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Chronic renal failure is usually the end results of variety of chronic conditions which include glomerulonephritis, obstructive uropathy, polycystic disease, renal artery stenosis and tubular dysfunction. Excretion of urinary citrate levels is dependent on renal functions i.e.glomerular filtration, tubular reabsorption, and excretion. Acid base status is thought to play a significant role in urinary citrate excretion. Alkalosis enhances citrate excretion, while acidosis decreases it. In acidosis, increased citrate utilization by the mitochondria in the tricarboxylic acid cycle occurs. This results in lower intracellular levels of citrate, facilitating citrate reabsorption and hence reducing citrate excretion. Citrate excretion is impaired by acidosis, hypokalemia (causing intracellular acidosis), a high–animal protein diet (with an elevated acid-ash content), and urinary tract infection (UTI). It has been assumed that decreased urinary citrate& increased serum citrate levels in renal failure and renal stone formers. The aim of this study was to confirm the association of decreased urinary citrate levels in renal failure patients.
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Author(s): Santhosh Kumar N Kalaivanam K N Mohammad Anwar Balu MahendranK
Urinary citrate, NPN substances, chronic renal failure (CRF), Kidney stones.