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Dissolution of Residual Microfragments with Citrate Therapy after Extracorporeal Shock Wave Lithotripsy
Author(s) -
Morimoto Shigeyoshi,
Uehara Masaki,
Yamauchi Toshiki,
Yasukawa Shu,
Ohkawa Tadashi
Publication year - 1996
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/j.1442-2042.1996.tb00352.x
Subject(s) - medicine , extracorporeal shock wave lithotripsy , dissolution , urology , calcium oxalate , lithotripsy , urine , surgery , chemistry
Residual microfragments after ESWL were studied for their presence and for possibility of dissolution with citrate therapy. Among 123 patients with renal stones who became stone–free following ESWL, a computed tomogram (CT) identified remaining microfragments within the treated kidney in 31.7% of the patients, even though stone fragments were not detectable on ordinary x–ray (KUU). The experiments, in which calcium oxalate stone fragments collected after ESWL were incubated in buffer solutions with citrate 0 to 4 mmol/L, showed that citrate dissolved the stone fragments. Using human urine as a solution, the dissolving effect was greater in spot urines after alkali citrate administration than in control urines. Eighteen patients with microfragments underwent a follow–up CT 3 months later. The results showed that the microfragments had disappeared in 6 of 11 (54.5%) patients who had been taking alkali citrate, whereas microfragments remained unchanged in all 5 patients without medication. Our results suggest that citrate therapy would be advisable as a prophylaxis for stone recurrence especially after ESWL treatment.