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

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 1000, 1600, and 2200. 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.