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The effect of sodium bicarbonate upon urinary citrate excretion in calcium stone formers.
Urology. 2013 Jul; 82(1):33-7.U

Abstract

OBJECTIVE

To evaluate the effects of oral sodium bicarbonate (NaBic) supplementation upon urinary citrate excretion in calcium stone formers (CSFs).

METHODS

Sixteen adult calcium stone formers with hypocitraturia were enrolled in a randomized, double-blind, crossover protocol using 60 mEq/day of NaBic during 3 days compared to the same period and doses of potassium citrate (KCit) supplementation. Blood and 24-hour urine samples were collected at baseline and during the third day of each alkali salt.

RESULTS

NaBic, similarly to KCit supplementation, led to an equivalent and significant increase in urinary citrate and pH. Compared to baseline, NaBic led to a significant increase in sodium excretion without concomitant increases in urinary calcium excretion, whereas KCit induced a significant increase in potassium excretion coupled with a significant reduction in urinary calcium. Although NaBic and KCit both reduced calcium oxalate supersaturation (CaOxSS) significantly vs baseline, KCit reduced calcium oxalate supersaturation significantly further vs NaBic. Both KCit and NaBic significantly reduced urinary phosphate and increased calcium phosphate supersaturation (CaPSS) compared to baseline. Finally, a significantly higher sodium urate supersaturation (NaUrSS) was observed after the use of the 2 drugs.

CONCLUSION

This short-term study suggests that NaBic represents an effective alternative for the treatment of hypocitraturic calcium oxalate stone formers who cannot tolerate or afford the cost of KCit. In view of the increased sodium urate supersaturation, patients with pure uric acid stones and high urate excretion may be less suited for treatment with NaBic.

Authors+Show Affiliations

Nephrology Division, Universidade Federal de São Paulo, São Paulo, Brazil.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23602798

Citation

Pinheiro, Vivian Barbosa, et al. "The Effect of Sodium Bicarbonate Upon Urinary Citrate Excretion in Calcium Stone Formers." Urology, vol. 82, no. 1, 2013, pp. 33-7.
Pinheiro VB, Baxmann AC, Tiselius HG, et al. The effect of sodium bicarbonate upon urinary citrate excretion in calcium stone formers. Urology. 2013;82(1):33-7.
Pinheiro, V. B., Baxmann, A. C., Tiselius, H. G., & Heilberg, I. P. (2013). The effect of sodium bicarbonate upon urinary citrate excretion in calcium stone formers. Urology, 82(1), 33-7. https://doi.org/10.1016/j.urology.2013.03.002
Pinheiro VB, et al. The Effect of Sodium Bicarbonate Upon Urinary Citrate Excretion in Calcium Stone Formers. Urology. 2013;82(1):33-7. PubMed PMID: 23602798.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The effect of sodium bicarbonate upon urinary citrate excretion in calcium stone formers. AU - Pinheiro,Vivian Barbosa, AU - Baxmann,Alessandra Calábria, AU - Tiselius,Hans-Göran, AU - Heilberg,Ita Pfeferman, Y1 - 2013/04/18/ PY - 2012/12/13/received PY - 2013/02/14/revised PY - 2013/03/01/accepted PY - 2013/4/23/entrez PY - 2013/4/23/pubmed PY - 2013/9/17/medline SP - 33 EP - 7 JF - Urology JO - Urology VL - 82 IS - 1 N2 - OBJECTIVE: To evaluate the effects of oral sodium bicarbonate (NaBic) supplementation upon urinary citrate excretion in calcium stone formers (CSFs). METHODS: Sixteen adult calcium stone formers with hypocitraturia were enrolled in a randomized, double-blind, crossover protocol using 60 mEq/day of NaBic during 3 days compared to the same period and doses of potassium citrate (KCit) supplementation. Blood and 24-hour urine samples were collected at baseline and during the third day of each alkali salt. RESULTS: NaBic, similarly to KCit supplementation, led to an equivalent and significant increase in urinary citrate and pH. Compared to baseline, NaBic led to a significant increase in sodium excretion without concomitant increases in urinary calcium excretion, whereas KCit induced a significant increase in potassium excretion coupled with a significant reduction in urinary calcium. Although NaBic and KCit both reduced calcium oxalate supersaturation (CaOxSS) significantly vs baseline, KCit reduced calcium oxalate supersaturation significantly further vs NaBic. Both KCit and NaBic significantly reduced urinary phosphate and increased calcium phosphate supersaturation (CaPSS) compared to baseline. Finally, a significantly higher sodium urate supersaturation (NaUrSS) was observed after the use of the 2 drugs. CONCLUSION: This short-term study suggests that NaBic represents an effective alternative for the treatment of hypocitraturic calcium oxalate stone formers who cannot tolerate or afford the cost of KCit. In view of the increased sodium urate supersaturation, patients with pure uric acid stones and high urate excretion may be less suited for treatment with NaBic. SN - 1527-9995 UR - https://www.unboundmedicine.com/medline/citation/23602798/The_effect_of_sodium_bicarbonate_upon_urinary_citrate_excretion_in_calcium_stone_formers_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0090-4295(13)00304-X DB - PRIME DP - Unbound Medicine ER -