Raising Urinary Citrate Lowers Calcium Oxalate and Calcium Phosphate Crystal Formation in Whole Urine

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Abstract
Crystal formation in whole urine was studied by the technique of rapid evaporation to 1,250 mosmol/l with and without raising citrate concentration by 40–50%. The added citrate reduced calcium oxalate crystal formation at pH 5.3 by about 25 % and reduced calcium phosphate crystal formation at pH 6.8 by some 42%. These results support the view that citrate is important in maintaining calcium in solution in whole urine, and that raising the urinary citrate could be effective treatment for calcium oxalate/phosphate urolithiasis.

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