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1. Diagnosing risk factors for patients with calcium kidney stones. 2. Monitoring results of therapy in patients with calcium stones or renal tubular acidosis.
Urinary citrate is a major inhibitor of kidney stone formation due in part to binding of calcium in urine. Low urine citrate levels are considered a risk for kidney stone formation. Several metabolic disorders are associated with low urine citrate. Any condition which lowers renal tubular pH or intracellular pH may decrease citrate (eg, metabolic acidosis, increased acid ingestion, hypokalemia, or hypomagnesemia). Low urinary citrate is subject to therapy by correcting acidosis, hypokalemia, or hypomagnesemia by altering diet or using drugs such as citrate and potassium.
No established reference values
1. A low value represents a potential risk for kidney stone formation/growth. Patients with low urinary citrate, and new or growing stone formation may benefit from adjustments in therapy known to increase urinary citrate excretion. 2. Very low levels suggest investigation for the possible diagnosis of metabolic acidosis (eg, renal tubular acidosis).