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.
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Article info
Publication history
Published online: April 19, 2013
Accepted:
March 1,
2013
Received:
December 13,
2012
Footnotes
Financial Disclosure: The authors declare that they have no relevant financial interests.
Funding Support: This research was supported by Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP - Grant: 2010/04719-1) and Fundação Oswaldo Ramos - Hospital do Rim e Hipertensão from Universidade Federal de São Paulo.
Identification
Copyright
© 2013 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
