You have accessJournal of UrologyStone Disease: Medical & Dietary Therapy1 Apr 2016PD31-08 PREVENTIVE EFFECT OF CITRATE AGAINST RECURRENT CALCIUM STONES DETECTED AS MICROCALCULI ON COMPUTED TOMOGRAPHY Rei Unno, Atsushi Okada, Kazumi Taguchi, Shuzo Hamamoto, Ryosuke Ando, Keiichi Tozawa, Kenjiro Kohri, and Takahiro Yasui Rei UnnoRei Unno More articles by this author , Atsushi OkadaAtsushi Okada More articles by this author , Kazumi TaguchiKazumi Taguchi More articles by this author , Shuzo HamamotoShuzo Hamamoto More articles by this author , Ryosuke AndoRyosuke Ando More articles by this author , Keiichi TozawaKeiichi Tozawa More articles by this author , Kenjiro KohriKenjiro Kohri More articles by this author , and Takahiro YasuiTakahiro Yasui More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.552AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Here we assessed whether microcalculi can indicate the management of calcium stone-forming patients to evaluate the effect of potassium-sodium citrate on renal microcalculi and examine the correlation between small stones and pain. METHODS A total of 217 male and female patients aged 20–80 years with a history of calcium component stones who visited our hospital between April 2009 and June 2014 were included. Patients were divided into those who did not receive potassium-sodium citrate (non-citrate group, n = 157) and those who did (citrate group, n = 60). In both groups, we evaluated blood and urine biochemistry and sediment, number of computed tomography-detected microcalculi, number of asymptomatic stone disappearances, and pain events. Observations were made at study initiation and 12 months later. RESULTS The citrate group showed significantly increased urine pH (p = 0.000002) and daily citrate excretion level (p = 0.00004). The non-citrate group showed increased numbers of microcalculi at study completion (p = 0.002); over the same period, the number of microcalculi in the citrate group decreased significantly (p = 0.03). Additionally, multivariable analysis showed more numerous asymptomatic stone disappearances (odds ratio [OR], 2.84; 95% confidence interval [CI], 1.49–5.39) and fewer pain events (OR, 0.37; 95% CI, 0.16–0.72) in the citrate group than in the non-citrate group. A sex-adjusted analysis demonstrated more numerous asymptomatic stone disappearances (OR, 3.96; 95% CI, 1.57–10.02) and fewer pain events (OR, 0.22; 95% CI, 0.07–0.70) after citrate treatment in women but not in men (Table). Increased microcalculi number and size were seen in patients who had painful events (30.0% and 52.8%, respectively). The incidence of microcalculi disappearance was significantly lower in patients who had painful events (17.1%). CONCLUSIONS Potassium-sodium citrate prevents the progression of renal microcalculi into symptomatic stones in calcium stone-forming patients. Increases in microcalculi significantly enhanced pain event onset, while the disappearance of microcalculi significantly decreased pain events. Our results suggest that microcalculi can be an indicator of the management of calcium stone-forming patients. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e720 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Rei Unno More articles by this author Atsushi Okada More articles by this author Kazumi Taguchi More articles by this author Shuzo Hamamoto More articles by this author Ryosuke Ando More articles by this author Keiichi Tozawa More articles by this author Kenjiro Kohri More articles by this author Takahiro Yasui More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...