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Calcium Phosphate Kidney StonesPhase 4NCT06003348

Hydroxycitrate: A Novel Therapy for Calcium Phosphate Urinary Stones

A Phase 4 study testing OHCit- standard dose, Potassium Citrate and OHCit- low dose in people with Calcium Phosphate Kidney Stones, run by University of Texas Southwestern Medical Center at 1 site in United States.

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Sites and contacts
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Trial summary

This study tests whether hydroxycitrate, a molecule closely related to citrate, can reduce calcium phosphate stone recurrence. Read more about this study

Who is it for?
Ages 21 to 99 years
Conditions the study is for
Calcium Phosphate Kidney Stones
What is being tested?
OHCit- standard dose, Potassium Citrate and OHCit- low dose
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
25 participants
Where
1 siteUnited States
Study dates
13 Dec 2023to 31 Aug 2028
Phase
Phase 4

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 21 to 99 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Calcium Phosphate stone formers

Who cannot join

  • History of recurrent urinary tract infections
  • Chronic diarrhea
  • Estimated Glomerular Filtration Rate (eGFR) < 45 ml/min/1.73 m2
  • History of primary hyperparathyroidism
  • Hypokalemia
  • Hyperkalemia
  • Pregnancy

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

United States1 site, 1 recruiting
  • UT Southwestern Medical Center

    Dallas, Texas, 75390-8885

    Naim M Maalouf, MD

    Recruiting

Other trials in United States

About this study

This study tests whether hydroxycitrate, a molecule closely related to citrate, can reduce calcium phosphate stone recurrence.

Read the detailed description

In this double-blind, placebo-controlled, randomized, crossover study, each participant will undergo 4 phases of study, with the order randomized by a blocked randomization scheme. The 4 phases will be Placebo, Super CitriMax (hydroxycitrate) OHCit low dose, OHCit standard dose, or Potassium Citrate. Randomization will be stratified based on sex, concomitant thiazide use, and concomitant alkali use.

Each phase will be 1 week in duration, during which subjects will take assigned study medications. A minimum 1-week washout period will be imposed between phases. During the first 2 days of each phase, subjects will be instructed to adhere to a prescribed diet. On the last 5 days of each phase, subjects will be kept on a constant metabolic diet. Use of metabolic diet is essential to eliminate confounders that could occur from changes in dietary intake across phases. During the final two study days (days 6-7), two 24-hr urines will be collected for urine biochemistry and crystallization studies. Fasting blood will be obtained at the end of the last urine collection.

Study Medications: Subjects will receive three tablets twice daily during each phase. These will consist of either placebo, Potassium Citrate (KCit), or Super CitriMax (OHCit). Study tablets will be prepared by a compounding pharmacy, with placebo tablets similar in appearance and size to the active medication tablets.

Being tested
OHCit- standard dose, Potassium Citrate, Placebo, OHCit- low dose
Keywords
Urolithiasis, Calcium phosphate, Citrate, Acid-base
Medical subject headings
Urolithiasis

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • OHCit- standard doseDietary supplement

    Also called Super Citrimax

    Hydroxycitrate Over-the-counter supplement, not FDA approved or regulated.

  • Potassium CitrateDrug

    Also called Urocit®-K

    10 mEq Extended-release tablets for oral use

  • PlaceboDrug

    Placebo

  • OHCit- low doseDietary supplement

    Also called Super Citrimax

    Hydroxycitrate Over-the-counter supplement, not FDA approved or regulated.

Study groups in NCT06003348
Study groupRoleWhat they receive
Potassium Citrate (Urocit®-K)Active comparatorPotassium Citrate KCit 10 mEq 2 tabs, twice daily and Placebo 1 tab, twice daily Total Daily Dose: Citrate 40 mEq/d
Receives: Drug: Potassium Citrate
Super CitriMax; OHCit-standard doseExperimentalSuper CitriMax 7 mEq 3 tabs, twice daily Total Daily Dose: OHCit 42 mEq/d
Receives: Dietary Supplement: OHCit- standard dose
Super CitriMax; OHCit-low doseExperimentalSuper CitriMax 7 mEq 2 tabs, twice daily And Placebo 1 tab, twice daily Total Daily Dose: OHCit 28 mEq/d
Receives: Dietary Supplement: OHCit- low dose
PlaceboPlacebo comparatorPlacebo 3 tablets twice daily Total Daily Dose: None
Receives: Drug: Placebo

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Formation product (FP) for Calcium Phosphate

    FP is obtained by adding increasing amounts of Calcium Chloride (CaCl2) to a series of urine aliquots maintained at constant pH for 2 hours, and is identified by the point at which calcium phosphate (CaP) precipitates as detected by an absorbance microplate reader.

    Calculated supersaturation using [Calcium] and [Phosphate] at that point represents FP.

    Measured: After 1 week of treatment

Secondary outcomes (2)
  1. Crystal growth of Calcium Phosphate

    We will assess crystal growth (CG) of CaP after seeding urine with a small amount of brushite (0.25 mg/ml urine) and incubating at 37°C for 3 hours (representing steady state) under constant stirring. A decrement in [Calcium]×[Phosphate] after seeding signifies crystal growth, while a [Calcium]×[Phosphate] increment represents crystal dissolution.

    Measured: After 1 week of treatment

  2. Calcium Phosphate supersaturation

    Supersaturation of calcium phosphate will be assessed by Joint Expert Speciation System (JESS).

    Measured: After 1 week of treatment

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted21 Aug 2023
  2. Study start13 Dec 2023
  3. Primary completion31 May 2028 (estimated)
  4. Study completion31 Aug 2028 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 4
Primary purpose
Prevention
Allocation
Randomised
Intervention model
Crossover
Model description
In this double-blind, placebo-controlled, randomized, crossover study, each participant will undergo 4 phases of study, with the order randomized by a blocked randomization scheme. The 4 phases will be Placebo, Super CitriMax (OHCit) low dose, Super CitriMax (OHCit) standard dose, or Potassium Citrate. Randomization will be stratified based on sex, concomitant thiazide use, and concomitant alkali use.
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
25 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06003348
Sponsor's protocol ID
2023-0339
Status last verified
Jun 2026
First submitted
14 Aug 2023
Last updated
2 Jun 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No

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