Potassium Citrate as a Preventive Treatment for Double-J Stent Encrustation: A Randomized Clinical Trial

This research was conducted to assess whether prophylactic citrate potassium can reduce double-J stent encrustation in patients with urolithiasis. In the present study, 70 patients with urolithiasis were randomly assigned to two groups of control [22 men; mean age 43 (33-55)] and intervention [25 men; mean age, 41 (37-56)] after meeting inclusion criteria. Potassium citrate (10 mEq Alithoral tablet) was administered three times a day from double-J stent insertion until removal in the intervention group. For the control group, no treatment was given. It was examined after removing the stent, and laboratory tests were performed in encrustation. Moreover, blood and urine were collected for assessing creatinine, crystalluria, and pyuria. Information concerning the duration of double-J stent placement, the composition of urinary stone (calcium oxalate or other), number of attack episodes, type of double-J stent (one way or other), and smoking habit were collected.   Three control group participants were excluded from the study due to missing follow-up. Patients of the two groups were matched for age, sex, duration of the double-J stent placement, and the number of attack episodes. There were significant differences regarding crystalluria and creatinine dosage between the two groups. Furthermore, double-J stent encrustation occurred in 3 (8.8%) and 11 (34.4%) patients of the intervention and control group, respectively, which showed a significant difference (P-value=0.012). Comparison between intervention and control group revealed an odds ratio of 18% (P-value=0.017) and 15% (P-value=0.023) in the crude and adjusted model, respectively.  Potassium citrate can significantly reduce double-J stent encrustation in patients with urolithiasis. Therefore, it is recommended that urologists consider citrate potassium as a preventive treatment for encrustation.