EFFICACY OF ORAL CITRATE ADMINISTRATION IN PRIMARY HYPEROXALURIA

Urinary citrate is a potent inhibitor of calcium oxalate (CaOx) crysta llization, but oral citrate has rarely been used in patients with prim ary hyperoxaluria (PH). We studied the effect of sodium citrate admini stration (0.1-0.15 g/kg/day) on urinary citrate excretion and CaOx sat uration in seven paediatric patients and the clinical response to long -term treatment (average 4 years) in five patients. Urinary citrate in creased from 0.73 to 2.54 mmol/24 h/1.73 m(2) and urinary saturation f or CaOx (calculated by equil 2) decreased from 11.41 to 6.79 (for both , p < 0.02). Long-term administration of alkali citrate [0.15 g (0.5 m mol)/kg/day] resulted in stable or improved renal function in three an d slow deterioration in two partially non-compliant patients. Alkali c itrate is effective in patients with PH.