| Title: |
Long-term citrate treatment in high-risk kidney stone formers is not associated with metabolic adverse effects |
| Authors: |
Ritter, Alexander; Bührer, Lea; Fuster, Daniel G; Dhayat, Nasser A; Bonny, Olivier; Wuerzner, Gregoire; Ernandez, Thomas; Buchkremer, Florian; Segerer, Stephan; Keller, Laura; Sabev, Maximilian; Engeler, Daniel S.; Roth, Beat; Ferraro, Pietro Manuel; Held, Ulrike; Mohebbi, Nilufar; Wagner, Carsten A.; Seeger, Harald |
| Source: |
ISSN:2048-8505 ; ISSN:2048-8513 ; Clinical Kidney Journal. |
| Publisher Information: |
Oxford University Press |
| Publication Year: |
2026 |
| Collection: |
ZHAW digitalcollection (Repository of the Zurich University of Applied Sciences) |
| Subject Terms: |
Body-mass index; Glucose; Lipid; Stone recurrence; Urine supersaturation; info:eu-repo/classification/ddc/616 |
| Description: |
Background: Citrate is frequently applied in kidney stone formers (KSFs), yet long-term safety data are lacking. We evaluated the effects of prolonged citrate therapy on metabolic health, urinary risk factors, and stone recurrence in high-risk KSFs in Switzerland. Methods: The Swiss Kidney Stone Cohort (SKSC) is a multicenter study including KSFs and controls. Blood and urine analyses were performed at baseline and longitudinally over two years in KSFs, with subsequent telephone follow-up for stone events. 654 KSFs (110 with citrate, 544 without) and 207 controls were included. Outcomes comprised anthropometric indices (BMI, body roundness index, waist-to-hip ratio), metabolic parameters, urinary relative supersaturation ratios (RSR), stone recurrence, and stone composition. Results: No evidence for between-group differences in 1–2-year changes in anthropometric, glucose, or lipid outcomes was identified. Anthropometric indices remained stable in both groups. HbA1c rose in NC but not in C patients. HDL cholesterol increased in both groups, while LDL decreased only in C patients. Propensity score–matched analyses showed no between-group differences in 1–2-year changes in anthropometric, glucose, or lipid outcomes, with only modest within-group changes in the C group (HbA1c, HDL and LDL cholesterol). Urine analyses showed a greater reduction in RSR for brushite among NC patients, whereas C patients had a stronger decline in uric acid (UA) RSR. Calcium oxalate RSR decreased similarly across groups. Stone recurrence was more frequent in C patients, with 43% versus 30% of NC patients changing stone type during follow-up. No shift toward calcium phosphate stones was observed in citrate users. Conclusions: Long-term citrate therapy appeared metabolically safe, and selectively reduced UA supersaturation, while non-treated patients showed a more pronounced decrease for brushite. Higher recurrence among treated patients may reflect different baseline risk. A prospective trial is warranted to clarify additive benefits of ... |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| Relation: |
https://doi.org/10.1093/ckj/sfag058; https://hdl.handle.net/11475/36016; https://digitalcollection.zhaw.ch/handle/11475/36016 |
| DOI: |
10.1093/ckj/sfag058 |
| Availability: |
https://hdl.handle.net/11475/36016; https://doi.org/10.1093/ckj/sfag058; https://digitalcollection.zhaw.ch/handle/11475/36016 |
| Rights: |
https://creativecommons.org/licenses/by/4.0/ |
| Accession Number: |
edsbas.22423BB5 |
| Database: |
BASE |