Comparison of the effects of sodium bicarbonate versus sodium citrate on renal acid excretion.
Citrate is used commonly as an alkalinizing agent and in the management of nephrolithiasis, but its quantitative effect on acid-base homeostasis, as judged by changes in renal net acid excretion, has not been delineated. We therefore administered 61 mEq of sodium citrate/day for 4 days to 10 normal volunteers and compared the results to those obtained in 10 normal subjects (4 of whom also participated in the citrate protocol) given 60 mEq/day for 4 days of sodium bicarbonate, the prototypical alkalinizing agent. We found that the sodium citrate group experienced an average reduction in net acid excretion (45.5 +/- 7.2 mEq/day) that was very similar to that (42.0 +/- 7.2 mEq/day) induced by the same amount of sodium bicarbonate. In both groups, the reduction in net acid excretion was equivalent to approximately 70% of the alkali administered. The latter appeared to relate to an average negative hydrogen ion balance of approximately 15 mEq/day, since there was an increase in blood [HCO3] in each group of about 2.5 mEq/l. We conclude that the findings demonstrate that the short-term effects of sodium citrate on acid-base homeostasis in normal subjects are indistinguishable from those of sodium bicarbonate.
Oster
J R
JR
Medical and Research Services, Veterans Administration Medical Center, Miami, Fla.
Stemmer
C L
CL
Perez
G O
GO
Vaamonde
C A
CA
D000143:Acids / Q000378:metabolism*; D000328:Adult; D001639:Bicarbonates / Q000494:pharmacology*; D002951:Citrates / Q000494:pharmacology*; D019343:Citric Acid; D004573:Electrolytes / Q000378:metabolism; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007668:Kidney / Q000187:drug effects / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D012964:Sodium / Q000494:pharmacology*; D017693:Sodium Bicarbonate
D000143:Acids; D001639:Bicarbonates; D002951:Citrates; D004573:Electrolytes; D019343:Citric Acid; D017693:Sodium Bicarbonate; D012964:Sodium