Evaluating the Effectiveness of Adding Magnesium Chloride to Conventional Protocol of Citrate Alkali Therapy in Children with Urolithiasis

Abstract

Background: 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 ‑ MgCl2 as oral supplements on urinary parameters in children with CaOx urolithiasis.

Methods: 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‑Cl2 (phase 2). Each phase of therapy lasted for 4 weeks.

Results: 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.

Conclusions: 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.

Key words: Children, magnesium chloride, nephrolithiasis, potassium citrate, urinary parameters