Potassium-magnesium citrate versus potassium chloride in thiazide-induced hypokalemia.
BACKGROUND
The purpose of this study was to compare the value of potassium-magnesium citrate (KMgCit) with potassium chloride in overcoming thiazide-induced hypokalemia.


METHODS
Sixty normal subjects first took hydrochlorothiazide (HCTZ; 50 mg/day). After three weeks of treatment (or earlier if hypokalemia developed), they were randomized to take KMgCit (42 mEq K, 21 mEq Mg, and 63 mEq citrate/day) or potassium chloride (42 mEq/day) for three weeks while continuing on HCTZ.


RESULTS
KMgCit significantly increased the serum potassium concentration from 3.42 +/- 0.30 mEq/L on HCTZ alone to about 3.8 mEq/L (P < 0.001). Potassium chloride produced a similar increase in serum potassium concentration from 3.45 +/- 0.44 mEq/L to about 3.8 mEq/L (P < 0. 001). KMgCit significantly increased the serum magnesium concentration by 0.11 to 0.12 mEq/L (P < 0.01), whereas potassium chloride produced a marginal decline or no significant change. KMgCit was less effective than potassium chloride in correcting HCTZ-induced hypochloridemia and hyperbicarbonatemia. KMgCit, but not potassium chloride, significantly increased urinary pH (by about 0.6 unit), citrate (by about 260 mg/day), and urinary magnesium.


CONCLUSIONS
KMgCit is equally effective as potassium chloride in correcting thiazide-induced hypokalemia. In addition, KMgCit, but not potassium chloride, produces a small but significant increase in serum magnesium concentration by delivering a magnesium load, and it confers alkalinizing and citraturic actions.
Wuermser
L A
LA
Center for Mineral Metabolism and Clinical Research, University of Texas, Southwestern Medical Center, Dallas, TX 75390-8885, USA. lisa.wuermser@email.swmed.edu
Reilly
C
C
Poindexter
J R
JR
Sakhaee
K
K
Pak
C Y
CY
D000328:Adult; D002951:Citrates / Q000008:administration & dosage* / Q000009:adverse effects / Q000652:urine; D004232:Diuretics; D004311:Double-Blind Method; D004338:Drug Combinations; D005260:Female; D006801:Humans; D006852:Hydrochlorothiazide / Q000009:adverse effects*; D006863:Hydrogen-Ion Concentration; D007008:Hypokalemia / Q000139:chemically induced* / Q000188:drug therapy* / Q000652:urine; D007669:Kidney Calculi / Q000139:chemically induced; D008274:Magnesium / Q000097:blood; D017616:Magnesium Compounds / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D011189:Potassium Chloride / Q000008:administration & dosage* / Q000009:adverse effects; D017680:Potassium Compounds / Q000008:administration & dosage* / Q000009:adverse effects; D049993:Sodium Chloride Symporter Inhibitors / Q000009:adverse effects*
D002951:Citrates; D004232:Diuretics; D004338:Drug Combinations; D017616:Magnesium Compounds; D017680:Potassium Compounds; D049993:Sodium Chloride Symporter Inhibitors; D006852:Hydrochlorothiazide; D011189:Potassium Chloride; D008274:Magnesium; C066902:potassium-magnesium citrate