Dr. Gary’s Nutritional Library

Potassium citrate is the most commonly used therapy for low urinary citrate levels (hypocitraturia). Hypocitraturia is seen in 13-63% of patients with recurrent urinary stones. Potassium citrate is the common therapy for kidney stones (nephrolithiasis) caused by calcium oxylate, uric acid or cystine. Citrate alkalinizes urine, prevents crystal formation and chelates calcium.

Chronic diarrhea reduces the absorption of citrates, reducing urinary release of citrate. This can complicate the treatment of nephrolithiasis, leading to continued pain from kidney stones.

Absorption of a commonly used tablet of potassium citrate can be altered by chronic diarrhea. Shenoy presents a case of a patient with chronic diarrhea and nephrolithiasis who continued to have hypocitraturia. She had passed some intact tablets of the pharmaceutical wax containing tablets in her bowel movements. This seemed to be due to the rapid passage of her bowel contents (increased transit time). When she was placed on a liquid potassium citrate supplement she developed normal levels of urinary citrate.

The patient’s urinary 24-hour citrate was 49 mg with normal being 320-1240 mg/24 hours. When she was switched to liquid potassium citrate her 24-hour urinary citrate increased to 455 mg.

CONCLUSION: Diarrhea can result in hypocitraturia, in spite of therapy with wax containing potassium citrate tablet therapy. This resolves with liquid potassium citrate therapy. Patients with nephrolithiasis and chronic diarrhea should use liquid or capsules of powdered potassium citrate rather than wax tablets.

NOTE: Supplements of potassium citrate available without prescription are limited to 99 mg. The patient was taking tablets of 1080 potassium citrate three times a day. Read about the effects of citrates on muscle fatigue.

ASK YOUR DOCTOR FOR: A urine citrate 24 hour citrate analysis. A urinary pH test would be informative, also.

To read the author’s abstract of the article click on the link to the author’s title of the article above.

PMID:17406150.

Summary #225.

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