Editing Stones: Evaluation and Medical Management (section)

==== <span style="color:#ff0000">Potassium citrate</span> ====
*'''<span style="color:#ff0000">Indications</span>'''
**'''<span style="color:#ff0000">Should be offered to patients with (2)</span>'''
**#'''<span style="color:#ff0000">Hypocitraturia AND</span>'''
**#'''<span style="color:#ff0000">Recurrent calcium or calcium phosphate stones</span>'''
**#*'''Citrates are first-line therapy for the management of RTA, thiazide-induced hypocitraturia, and idiopathic hypocitraturia'''
**#** Potassium citrate therapy is able to correct the metabolic acidosis and hypokalemia found in patients with distal RTA
**#*'''Calcium stone-forming patients with normal citrate excretion but low urinary pH may also benefit from citrate therapy'''
**#**There is also a risk that higher urine pH can promote calcium phosphate stone formation, or change calcium oxalate stone formers to calcium phosphate stone formers.
**#* '''Potassium citrate is preferred over sodium citrate'''
**#**'''Patient's treated with sodium alkali will occasionally begin forming calcium oxalate stones due to an excess sodium load that will inhibit reabsorption of calcium in the proximal tubule, thereby causing hypercalciuria'''
**#**'''If the patient is at risk for hyperkalemia, other agents such as sodium bicarbonate or sodium citrate should be considered.'''
*'''<span style="color:#ff0000">Adverse Events (2)</span>'''
**'''<span style="color:#ff0000">Hyperkalemia</span>'''
**'''<span style="color:#ff0000">GI upset</span>'''