The effect and factor analysis of potassium sodium hydrogen citrate on the formation of double J tube wall stones after ureteral stone surgery.

BACKGROUND

Double-J (DJ) ureteral stent encrustation is a frequent complication after ureteroscopic lithotripsy (URS), leading to infections, obstruction and difficult stent removal. Potassium sodium hydrogen citrate may reduce encrustation by alkalinizing urine and increasing urinary citrate excretion.

OBJECTIVES

To evaluate the effect of potassium sodium hydrogen citrate on DJ stent encrustation and to identify biochemical, clinical and microbiological predictors following ureteral stone surgery.

METHODS

This retrospective comparative study included 110 adults undergoing URS with DJ stenting. Group A (n=55) received potassium sodium hydrogen citrate for 4 weeks, while Group B (n=55) served as control. Patients were followed for urinary parameters, complications and stent encrustation graded at removal. Multivariate regression and ROC analyses identified predictors of significant encrustation.

RESULTS

Grade 0 encrustation was higher in Group A (65.45% vs. 36.36%; p=0.003). Urinary pH and citrate were higher in Group A (p<0.001). Low urinary citrate, low pH and positive urine culture predicted Grade ≥2 encrustation. Urinary citrate showed strongest predictive value (AUC 0.821).

CONCLUSION

Potassium sodium hydrogen citrate reduces DJ stent encrustation severity by modifying urinary biochemistry and may enhance postoperative outcomes.