PD21-08 OVER-THE-COUNTER ALKALI AGENTS TO RAISE URINE PH AND CITRATE EXCRETION: A PROSPECTIVE CROSSOVER STUDY IN HEALTHY ADULTS

Abstract

You have accessJournal of UrologyStone Disease: Medical & Dietary Therapy (PD21)1 Sep 2021PD21-08 OVER-THE-COUNTER ALKALI AGENTS TO RAISE URINE PH AND CITRATE EXCRETION: A PROSPECTIVE CROSSOVER STUDY IN HEALTHY ADULTS Noah Canvasser, Marcelino Rivera, Seth Bechis, Johann Ingimarsson, John Knoedler, Karen Stern, Christa Stoughton, Daniel Wollin, Michael Borofsky, Naeem Bhojani, Marawan El Tayeb, Guido Kamphuis, David Leavitt, Ryan Hsi, and Kymora Scotland Noah CanvasserNoah Canvasser More articles by this author , Marcelino RiveraMarcelino Rivera More articles by this author , Seth BechisSeth Bechis More articles by this author , Johann IngimarssonJohann Ingimarsson More articles by this author , John KnoedlerJohn Knoedler More articles by this author , Karen SternKaren Stern More articles by this author , Christa StoughtonChrista Stoughton More articles by this author , Daniel WollinDaniel Wollin More articles by this author , Michael BorofskyMichael Borofsky More articles by this author , Naeem BhojaniNaeem Bhojani More articles by this author , Marawan El TayebMarawan El Tayeb More articles by this author , Guido KamphuisGuido Kamphuis More articles by this author , David LeavittDavid Leavitt More articles by this author , Ryan HsiRyan Hsi More articles by this author , and Kymora ScotlandKymora Scotland More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002010.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Urinary citrate is a potent inhibitor of kidney stones; hypocitraturia is a common abnormality in the recurrent stone former. The American Urological Association guidelines specifically recommend potassium citrate for urinary alkalization based on the significant improvement in urinary parameters, and the reduced risk of recurrent stone disease. However, there is poor adherence to prescribed potassium citrate therapy. More recently, patients have had increased access to alternative over-the-counter alkali preparations. Our goal was to assess the effect of two over-the-counter alkalizing agents on 24-hour urinary parameters in healthy adults without a history of kidney stones. METHODS: Ten healthy volunteers without a history of kidney stones were recruited to complete a baseline 24-hour urinalysis with a four-day diet inventory. Participants were randomized 1:1 to take LithoLyte® (20 mEq two times per day) or KSPtabsTM (1 tablet two times per day) while maintaining the same diet and submit another 24-hour urinalysis. The process was repeated with the other supplement. Urinary parameters including citrate, pH and ammonium were compared to baseline. Side effects of each supplement were elicited with a questionnaire after each urine collection. RESULTS: LithoLyte® intake resulted in a non-significant increase in citrate (597 to 758 mg/day, p=0.058, an increase in urine pH (6.46 to 6.66, p=0.028), and a decrease in urine ammonium (41 to 36 mmol/day, p=0.005) compared to baseline (table 1). KSPtabsTM resulted in an increase in citrate (597 to 797 mg/day, p=0.037) and urine pH (6.46 to 6.86, p=0.037), with a non-significant decrease in ammonium (41 to 34 mmol/day, p=0.059). No significant differences were seen comparing urinary analytes between LithoLyte® and KSPtabsTM supplements. With Litholyte®, no side effects, mild, moderate, and severe side effects were seen in 50%, 40%, 10%, and 0%, respectively. With KSPtabsTM, rates were 60%, 20%, 10%, and 10%, respectively. CONCLUSIONS: In healthy participants without a history of kidney stones, LithoLyte® and KSPtabsTM are effective over-the-counter alkali supplements. Their side effect profiles appear similar to prescription potassium citrate. Source of Funding: This was an investigator-initiated project where the protocol, data collection, statistical analysis and drafting of the manuscript was performed by the authors. The study supplements, Litholyte® and KSPtabsTM, and 24-hour urine testing were funded by the manufacturers © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e377-e377 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Noah Canvasser More articles by this author Marcelino Rivera More articles by this author Seth Bechis More articles by this author Johann Ingimarsson More articles by this author John Knoedler More articles by this author Karen Stern More articles by this author Christa Stoughton More articles by this author Daniel Wollin More articles by this author Michael Borofsky More articles by this author Naeem Bhojani More articles by this author Marawan El Tayeb More articles by this author Guido Kamphuis More articles by this author David Leavitt More articles by this author Ryan Hsi More articles by this author Kymora Scotland More articles by this author Expand All Advertisement Loading ...