Efficacy of Oral Potassium Citrate in Reducing Double-J Ureteric Stent Encrustations: A Retrospective Cohort Study from a Single Tertiary Care Center: Oral Potassium Citrate in Reducing Double-J Ureteric Stent Encrustations

Muhammad Irfan; Usman Khalid Cheema; Talal Habib; Ikrama Bin Manzoor; Rao Nouman Ali

doi:10.54393/pjhs.v7i8.4107

Authors

Muhammad Irfan Department of Urology, University Teaching Hospital, Gujranwala, Pakistan
Usman Khalid Cheema Department of Urology, University Teaching Hospital, Gujranwala, Pakistan
Talal Habib Department of Urology, University Teaching Hospital, Gujranwala, Pakistan
Ikrama Bin Manzoor Department of Urology, University Teaching Hospital, Gujranwala, Pakistan
Rao Nouman Ali Department of Urology, District Headquarters Hospital, Khanewal, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v7i8.4107

Keywords:

Double-J Stent, Encrustations, Potassium Citrate, Urine Alkalinization, Stent Complications

Abstract

Double-J (DJ) ureteric stent encrustation is a significant complication in endourological practice. The role of oral potassium citrate in mitigating stent encrustations remains inadequately studied. Objectives: To evaluate the efficacy of oral potassium citrate supplementation in reducing DJ stent encrustations and identify associated risk factors. Methods: A retrospective cohort study was conducted at Gujranwala Teaching Hospital (October 2022 to October 2025) involving 504 patients with DJ stents. Group 1 (n=249) received oral potassium citrate (20 mEq twice daily) until stent removal; Group 2 (n=255) received no supplementation. Encrustation was assessed using the KUB grading system. Results: Overall encrustation prevalence was 18.05% (91/504) with a mean KUB score of 6.2 ± 2.90. Encrustation rates were significantly lower in Group 1 (5.2%) versus Group 2 (30.58%) (p<0.001). Urinary tract infections were more common in Group 2 (55.8%) than in Group 1 (30%) (p=0.006). Multivariate regression identified non-utilization of potassium citrate (adjusted OR: 0.52, 95% CI: 0.37-0.74), prolonged indwelling duration >180 days (adjusted OR: 3.45, 95% CI: 2.41-4.94), and male gender (adjusted OR: 1.62, 95% CI: 1.18-2.23) as independent predictors (all p<0.005). Conclusions: Oral potassium citrate supplementation significantly reduced DJ stent encrustations. Male gender, prolonged indwelling time, and non-utilization of potassium citrate were strong independent predictors. Prospective randomized trials are recommended to validate these findings.

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