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.