Use

Urinary citrate is a major inhibitor of kidney stone formation due in part to binding of calcium in urine. Low urine citrate levels are considered a risk for kidney stone formation. Several metabolic disorders associated with low urine citrate include conditions that lower renal tubular or intracellular pH, such as metabolic acidosis, hypokalemia, or hypomagnesemia. Very low citrate levels suggest investigation for possible metabolic acidosis (e.g., renal tubular acidosis). Monitoring urinary citrate is useful in patients with calcium stones or renal tubular acidosis. For children ages 5 to 18, a citrate/creatinine ratio less than 0.176 mg citrate/mg creatinine is below the 5th percentile and considered low.