Comparison of the Effects of Potassium Polycitrate with No Treatment on Microlithiasis of the Infants Referred to a Pediatric Nephrology Clinic

Microlithiasis is a common increasing disorder, especially in infants and young children, defined as sonographic detection of hyperechogenic deposits in the pelvic area of the ureter and calyces which are less than 3 mm in diameter. Potassium citrate is one of the drugs used in nephrolithiasis. Citrate prevents the formation of calcium deposits. It also inhibits calcium oxalate crystals, which can be the nidus for kidney stones. The aim of this study was to compare the effect of potassium polycitrate versus no treatment in the infants with microlithiasis.

In this descriptive-retrospective study, 112 patients referred to a pediatric nephrology clinic were enrolled. Children less than two years old with microlithiasis in kidneys or urinary tract confirmed by ultrasonography imaging were included in the study. Patients were randomly divided into two groups: the first group received potassium citrate solution of 1-2 mEq/kg of body weight daily for two months, and the second group did not receive any specific medication. Follow-up was performed every two months for six months using ultrasound by a skilled radiologist with a fixed ultrasound device. To minimize drug side effects and treatment response, the allergic responses were measured once every two months, and the physician decided drug will or will not continue. Data analysis was done by SPSS 19. The P values <0.05 were considered significant.

The mean age of the study population was 4.13 ± 2.27 months. The mean weight in the total study population was 6.62±1.36 kg and the mean birth weight in the total study population was 3±0.41 kg. According to the results of the study, the decrease in the size or number of stones in one or both kidneys was more in the recipients of polycitrate solution and the increase in the size or number of stones in one or both kidneys was more in the infants not receiving polycitrate (P<0.001).

Factors such as age, sex, current weight, birth weight and type of nutrition have no effect on improving and/or reducing the size and number of renal stones. However, in the group receiving potassium polycitrate solution, there was a significant reduction in the size and number of stones compared to the non-receiving group.