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Comparison potassium sodium hydrogen citrate with sodium bicarbonate in urine alkalization: a prospective crossover-controlled trial

  • Urology - Original Paper
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Abstract

Purpose

Excessive alkalization will increase the incidence of nephrolithiasis. Sodium bicarbonate (NaHCO3) and potassium sodium hydrogen citrate (PSHC) are commonly used drugs for urinary alkalization. We designed a trial to compare PSHC with NaHCO3 in the urine alkalization for the Chinese healthy participants and to explore the effects of PSHC and NaHCO3 on circadian rhythms of urine pH value.

Method

This study was a prospective, crossover, randomized, controlled trial, in which a total of 34 healthy volunteers participated in two study phases and took PSHC and NaHCO3 at the maintenance dose, respectively.

Result

The average level of urine pH of PSHC participants in 24 h was significantly higher than that of NaHCO3 (P < 0.001). The urine pH value of participants taking PSHC and NaHCO3 or under physiological conditions showed significant variation in 24 h (P < 0.05) and fitted to a mathematical model (Fourier series). Under physiological conditions, the average urine pH value in the daytime was higher than that in the night, and reached the peak at about 10:00, 16:00, and 22:00. The peak of urine pH at 24 h after taking PSHC and NaHCO3 was both higher than the baseline. The peak time of urine pH and the curve trend were similar, but the peak value in PSHC group was significantly higher than that in NaHCO3 group.

Conclusions

There was a circadian rhythm of urine pH value under physiological conditions. PSHC was more effective in urinary alkalization than NaHCO3 at the current maintenance oral dose and administration time without changing the rhythm of urine pH value.

Clinical trial registration

NCT04352153.

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Acknowledgements

The authors would like to thank the patients for their participation. In addition, the authors wish to thank the National Natural Science Foundation of China for providing the financial support for this study.

Funding

This study was funded by the National Natural Science Foundation of China (No. 81970756) and Shanghai Tenth People’s Hospital of Tongji University (Nos. 040120069 and 040319136).

Author information

Author notes

  1. Wen Xue, Jiafen Cheng, and Jing Zhao have contributed equally to this work.

Authors and Affiliations

  1. Department of Nephrology, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, 301 Yanchang Middle Road, Shanghai, 200072, People’s Republic of China

    Wen Xue, Jiafen Cheng, Jing Zhao, Ling Wang, Ai Peng & Xinying Liu

Authors
  1. Wen Xue
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  2. Jiafen Cheng
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  3. Jing Zhao
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  4. Ling Wang
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Contributions

WX: manuscript preparation and project development. JZ: manuscript preparation and data statistical analysis. LW: patient inclusion and management. AP: project development and study design. JC: study design and manuscript preparation. XL: project development and study design.

Corresponding author

Correspondence to Xinying Liu.

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Conflict of interest

The authors declare no financial competing interests.

Ethical approval

All procedures conducted in studies with participants involved complied with the 1964 Helsinki declaration and its later comparable or amendments ethical standards, and with the ethical standards of Shanghai Tenth People’s Hospital (Ethics Approval No. SHSY-IEC-4.1/20-4/01).

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All study participants provided informed consent before enrollment.

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Patients signed informed consent regarding publishing the study data.

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Xue, W., Cheng, J., Zhao, J. et al. Comparison potassium sodium hydrogen citrate with sodium bicarbonate in urine alkalization: a prospective crossover-controlled trial. Int Urol Nephrol 55, 61–68 (2023). https://doi.org/10.1007/s11255-022-03387-y

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