Potassium citrate is an alkaline agent recommended to prevent nephrolithiasis. It works by making the urine less acidic and more alkaline. It helps decrease the uric acid in the body by actually increasing the citrate and potassium levels and raising the pH level of urine. (1)
The Onset of Renal Tubular Acidosis:
Renal Tubular Acidosis is a condition where the kidneys cannot maintain normal acid-base homeostasis due to tubular defects in acid excretion or bicarbonate ion reabsorption. It is seen that the kidneys are the responsible organ for the maintenance of the acid-base homeostasis when they reabsorb HCO3 in the proximal tubule. The brainstem and lungs also maintain the acid-base homeostasis function. (1)
Sometimes widespread proximal tubular dysfunction loses phosphate, glucose, uric acid, amino acids, low molecular weight proteins and HCO3. Skeletal abnormalities result from impaired phosphate reabsorption. The condition of Osteopenia may also be observed due to acidosis-induced bone demineralization.
Potassium Citrate is used to treat the condition of kidney stones, called Renal Tubular Acidosis (RTA). It is also used to prevent any kidney stones with gout. The treatment with potassium citrate in the correction of metabolic acidosis is efficient. It may be associated with improvement in bone quality as well.
Potassium Citrate: Administration and Side Effects
Potassium Citrate is usually administered as a dietary supplement. Sometimes the treatment includes diet and lifestyle modifications such as increased intake of citrus fruit and fluids, restricted intake of sodium oxalate, fructose and animal protein and regular calcium intake. Alkali based fruits and vegetables such as bananas, spinach, kale, celery, beet greens, sweet potato, and kiwi are also helpful.
Potassium Citrate should be administered under medical prescription only. It can be harmful in Addison’s disease, diabetic ketoacidosis, cardiac arrest, oesophageal compression, ulcers due to stomach acid and kidney failures. It is not recommended for use by pregnant and lactating mothers, administration along with alcohol, or in patients with kidney and liver conditions. Its administration in heart failures, oesophagus compression and stomach muscle paralysis must also be avoided.
During treatment with Potassium Citrate, complications may be diarrhoea, nausea, vomiting, abdominal pain, allergy, and paralysis in extreme cases. The treatment should be undertaken under medical supervision only. (2)
The dosage of potassium citrate therapy in case of severe hypocitraturia is an initial dose of 60 mEq orally per day. In case of moderate hypocitraturia (urinary citrate over 150 mg/day), the initial dose is 30 mEq orally per day. (3)
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