{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T09:11:38Z","timestamp":1778836298082,"version":"3.51.4"},"reference-count":51,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T00:00:00Z","timestamp":1773014400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001711","name":"Swiss National Science Foundation","doi-asserted-by":"publisher","award":["183774"],"award-info":[{"award-number":["183774"]}],"id":[{"id":"10.13039\/501100001711","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,5,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Citrate is frequently applied in kidney stone formers (KSFs), yet long-term safety data are lacking. We evaluated the effects of prolonged citrate therapy on metabolic health, urinary risk factors and stone recurrence in high-risk KSFs in Switzerland.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The Swiss Kidney Stone Cohort (SKSC) is a multicenter study including KSFs and controls. Blood and urine analyses were performed at baseline and longitudinally over 2 years in KSFs, with subsequent telephone follow-up for stone events. A total of 654 KSFs (110 with citrate, 544 without) and 207 controls were included. Outcomes comprised anthropometric indices (body mass index, body roundness index, waist-to-hip ratio), metabolic parameters, urinary relative supersaturation ratios (RSR), stone recurrence and stone composition.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>No evidence for between-group differences in 1- to 2-year changes in anthropometric, glucose or lipid outcomes was identified. Anthropometric indices remained stable in both groups. HbA1c rose in non-citrate (NC) but not in citrate (C) group patients. High-density lipoprotein (HDL) cholesterol increased in both groups, while low-density lipoprotein (LDL) decreased only in C patients. Propensity score\u2013matched analyses showed no between-group differences in 1- to 2-year changes in anthropometric, glucose or lipid outcomes, with only modest within-group changes in the C group (hemoglobin A1c, HDL- and LDL-cholesterol). Urine analyses showed a greater reduction in RSR for brushite among NC patients, whereas C patients had a stronger decline in uric acid (UA) RSR. Calcium oxalate RSR decreased similarly across groups. Stone recurrence was more frequent in C patients, with 43% versus 30% of NC patients changing stone type during follow-up. No shift toward calcium phosphate stones was observed in citrate users.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Long-term citrate therapy appeared metabolically safe, and selectively reduced UA supersaturation, while non-treated patients showed a more pronounced decrease for brushite. Higher recurrence among treated patients may reflect different baseline risk. A prospective trial is warranted to clarify additive benefits of citrate beyond dietary-guided counseling.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ckj\/sfag058","type":"journal-article","created":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T12:42:11Z","timestamp":1772800931000},"source":"Crossref","is-referenced-by-count":0,"title":["Long-term citrate treatment in high-risk kidney stone formers is not associated with metabolic adverse effects"],"prefix":"10.1093","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9049-0765","authenticated-orcid":false,"given":"Alexander","family":"Ritter","sequence":"first","affiliation":[{"name":"Division of Nephrology, University Hospital Zurich , Zurich ,","place":["Switzerland"]},{"name":"Division of Nephrology and Transplantation Medicine, HOCH Cantonal Hospital St Gallen , St Gallen ,","place":["Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lea","family":"B\u00fchrer","sequence":"additional","affiliation":[{"name":"Biostatistics and Prevention Institute, University of Zurich Department of Biostatistics and Epidemiology, , Zurich ,","place":["Switzerland"]},{"name":"Centre for Computational Health, Institute of Computational Life Sciences, Zurich University of Applied Sciences (ZHAW) , W\u00e4denswil ,","place":["Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7220-1803","authenticated-orcid":false,"given":"Daniel G","family":"Fuster","sequence":"additional","affiliation":[{"name":"Inselspital, Bern University Hospital, University of Bern Department of Nephrology and Hypertension, ,","place":["Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8310-5921","authenticated-orcid":false,"given":"Nasser A","family":"Dhayat","sequence":"additional","affiliation":[{"name":"B. 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