title: Comparison of the effects of sodium bicarbonate versus sodium citrate on renal acid excretion.
abstract: 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.
authors.affiliation: Medical and Research Services, Veterans Administration Medical Center, Miami, Fla.
authors.forename: J R
authors.initials: JR
authors.lastname: Oster
authors.forename: C L
authors.initials: CL
authors.lastname: Stemmer
authors.forename: G O
authors.initials: GO
authors.lastname: Perez
authors.forename: C A
authors.initials: CA
authors.lastname: Vaamonde
mesh_terms: 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
chemical_list: D000143:Acids; D001639:Bicarbonates; D002951:Citrates; D004573:Electrolytes; D019343:Citric Acid; D017693:Sodium Bicarbonate; D012964:Sodium