Evaluating the effectiveness of adding magnesium chloride to conventional protocol of citrate alkali therapy in children with urolithiasis

ABSTRACT

Potassium citrate [K-Cit] is one of the medications widely used in patients with urolithiasis. However, in some cases with calcium oxalate [CaOx] urolithiasis, the significant response to alkaline therapy with K-Cit alone does not occur. There is scarce published data on the effect of magnesium chloride [Mg-Cl2] on urolithiasis in pediatric patients. This study aimed to evaluate the effect of a combination of K-Cit - MgCl[2] as oral supplements on urinary parameters in children with CaOx urolithiasis. This study was conducted on 24 children with CaOx urolithiasis supplements included potassium citrate [K-Cit] and magnesium chloride [Mg-Cl2]. The serum and urinary electrolytes were measured before [phase 0] and after prescribing K-Cit alone [phase 1] and a combination of K-Cit and Mg-Cl[2] [phase 2]. Each phase of therapy lasted for 4 weeks. The mean age of patients was 6.46 +/- 2.7 years. Hyperoxaluria and hypercalciuria were seen in 66% and 41% of patients, respectively. Serum magnesium increased significantly during phase 2 comparing with phase 0. Urinary citrate level was significantly higher in phase 1 and 2 in comparison with phase 0, P < 0.05. In addition, urinary oxalate excretion was significantly diminished in phase 2 comparing with phase 0 and 1, P < 0.05. Soft stool was reported by 4 patients, but not severe enough to discontinue medications. These results suggested that a combination of K-Cit and Mg-Cl2 chloride is more effective on decreasing urinary oxalate excretion than K-Cit alone. The Iranian Clinical Trial registration number IRCT138707091282N1