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Old 05-06-2013
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Kidney when to give potassium citrate in renal stones?

Hey guys, when are we supposed to give potassium citrate in renal stones?
Only when citrate is deficient in diet?
Or in uric acid stones to dissolve them? Isnt iv fluids first step in all stones treatment if less than 5 mm?
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Old 05-06-2013
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Quote:
Originally Posted by Ace843 View Post
Hey guys, when are we supposed to give potassium citrate in renal stones?
Only when citrate is deficient in diet?
Or in uric acid stones to dissolve them? Isnt iv fluids first step in all stones treatment if less than 5 mm?
Treatment of Uric Acid Stones:
Uric acid stones are highly soluble in alkaline urine. Alkalinization of urine > 6.5 with oral Potassium Bicarb. or Potassium Citrate is indicated for Uric Acid stones. Also, purine restricted diet is helpful and Allopurinol must be started.

As far as I know, you increase oral fluid intake (not IV) to more than 2L/day as first step in all acute stones less than 5mm. This is recommended in acute cases but doesn't help much in recurrent stones. If between .5 - 3cm then go for ESWL. In some cases you cant use ESWL (i.e pregnant woman), then you go for alternative methods like percutaneous nephrostomy. Do not forget that the most important first step is pain management with an NSAID (Ketorolac).

Treatment of Recurrent Hypercalciuric Stones:
1. Increase fluid intake & restrict protein in diet
2. dietry sodium restriction
3. thiazide/amiloride directics (inc. reabsorption of Ca++)

Hope this helps
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The above post was thanked by:
Ace843 (05-07-2013), Brainiac (05-07-2013), gear2d (05-06-2013), ibrar (05-31-2015), Noa2013 (02-23-2015), radkur (05-07-2013), venky2600 (05-06-2013)



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