Document Detail

Does citrate prevent nephrocalcinosis in preterm neonates?
MedLine Citation:
PMID:  17039333     Owner:  NLM     Status:  MEDLINE    
Nephrocalcinosis (NC) occurs frequently in preterm neonates. A high U-calcium/citrate is one of the contributing factors to the development of NC. In stone-forming children and adults citrate supplementation is a successful preventive therapy. In this randomized controlled trial the effect of citrate therapy was studied on the development of NC in preterm neonates with a gestational age <32 weeks. Thirty-eight preterm neonates (mean gestational age 29.8 weeks (SD 1.6), mean birth weight 1,300 g (SD 351) were treated with sodium citrate (0.52 mmol/kg/day in four doses) from day 8 of life until at term and 36 preterm neonates (mean gestational age 29.6 weeks (SD 1.6), mean birth weight 1,282 g (SD 256) were not treated. U-calcium, U-creatinine, U-citrate and U-pH were measured at day 7, 14, 21, 28 of life and at term. Renal ultrasonography (US) was performed at term. U-citrate/creatinine and U-pH were significantly higher and U-calcium/citrate was significantly lower in the citrate group at day 14, 21 and 28 compared with the control group (P<0.05). Complications of citrate administration were not encountered, however the incidence of NC was not significantly different in the treated (34%) compared with the control group (44%), P=0.37. Preterm neonates treated with citrate in the first months of life have higher U-citrate/creatinine and lower U-calcium/citrate compared with controls. Sodium citrate therapy in a dosage of 0.52 mmol/kg/day is safe but does not prevent NC. Whether a higher dose or potassium citrate decreases the incidence of NC should be evaluated in further studies.
Eveline A Schell-Feith; Aukje Moerdijk; Paul H T van Zwieten; Harmine M Zonderland; Herma C Holscher; Joana Kist-van Holthe; Bert J van der Heijden
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial     Date:  2006-10-13
Journal Detail:
Title:  Pediatric nephrology (Berlin, Germany)     Volume:  21     ISSN:  0931-041X     ISO Abbreviation:  Pediatr. Nephrol.     Publication Date:  2006 Dec 
Date Detail:
Created Date:  2006-11-09     Completed Date:  2007-10-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8708728     Medline TA:  Pediatr Nephrol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  1830-6     Citation Subset:  IM    
Department of Pediatrics, Sophia Children's Hospital, Rotterdam, The Netherlands.
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MeSH Terms
Citric Acid / pharmacology*
Infant, Newborn
Infant, Premature / physiology*
Nephrocalcinosis / prevention & control*
Reg. No./Substance:
77-92-9/Citric Acid

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