Potassium citrate supplementation results in sustained improvement in calcium balance in older men and women
Open Access
- 18 September 2012
- journal article
- research article
- Published by Oxford University Press (OUP) in Journal of Bone and Mineral Research
- Vol. 28 (3), 497-504
- https://doi.org/10.1002/jbmr.1764
Abstract
The dietary acid load created by the typical Western diet may adversely impact the skeleton by disrupting calcium metabolism. Whether neutralizing dietary acid with alkaline potassium salts results in sustained improvements in calcium balance remains controversial. In this randomized, double‐blind, placebo‐controlled study, 52 men and women (mean age 65.2 ± 6.2 years) were randomly assigned to potassium citrate 60 mmol/d, 90 mmol/d, or placebo daily with measurements of bone turnover markers, net acid excretion, and calcium metabolism, including intestinal fractional calcium absorption and calcium balance, obtained at baseline and at 6 months. At 6 months, net acid excretion was significantly lower in both treatment groups compared to placebo and it was negative, meaning subjects' dietary acid was completely neutralized (−11.3 mmol/d on 60 mmol/d; −29.5 mmol/d on 90 mmol/d, p < 0.001 compared to placebo). At 6 months, 24‐hour urine calcium was significantly reduced in persons taking potassium citrate 60 mmol/d (−46 ± 15.9 mg/d) and 90 mmol/d (−59 ± 31.6 mg/d) compared with placebo (p < 0.01). Fractional calcium absorption was not changed by potassium citrate supplementation. Net calcium balance was significantly improved in participants taking potassium citrate 90 mmol/d compared to placebo (142 ± 80 mg/d on 90 mmol/d versus −80 ± 54 mg/d on placebo; p = 0.02). Calcium balance was also improved on potassium citrate 60 mmol/d, but this did not reach statistical significance (p = 0.18). Serum C‐telopeptide decreased significantly in both potassium citrate groups compared to placebo (−34.6 ± 39.1 ng/L on 90 mmol/d, p = 0.05; −71.6 ± 40.7 ng/L on 60 mmol/d, p = 0.02) whereas bone‐specific alkaline phosphatase did not change. Intact parathyroid hormone was significantly decreased in the 90 mmol/d group (p = 0.01). Readily available, safe, and easily administered in an oral form, potassium citrate has the potential to improve skeletal health. Longer‐term trials with definitive outcomes such as bone density and fracture are needed. © 2013 American Society for Bone and Mineral Research.Keywords
This publication has 26 references indexed in Scilit:
- The 2011 Report on Dietary Reference Intakes for Calcium and Vitamin D from the Institute of Medicine: What Clinicians Need to KnowJournal of Clinical Endocrinology & Metabolism, 2011
- Treatment with Potassium Bicarbonate Lowers Calcium Excretion and Bone Resorption in Older Men and WomenJournal of Clinical Endocrinology & Metabolism, 2009
- Partial Neutralization of the Acidogenic Western Diet with Potassium Citrate Increases Bone Mass in Postmenopausal Women with OsteopeniaJournal of the American Society of Nephrology, 2006
- Effects of Potassium Citrate Supplementation on Bone MetabolismCalcified Tissue International, 2004
- Potassium Citrate Prevents Increased Urine Calcium Excretion and Bone Resorption Induced by a High Sodium Chloride DietJournal of Clinical Endocrinology & Metabolism, 2002
- Improved Mineral Balance and Skeletal Metabolism in Postmenopausal Women Treated with Potassium BicarbonateNew England Journal of Medicine, 1994
- Validation of a self-administered diet history questionnaire using multiple diet recordsJournal of Clinical Epidemiology, 1990
- Potassium bicarbonate, but not sodium bicarbonate, reduces urinary calcium excretion and improves calcium balance in healthy menKidney International, 1989
- Urinary bicarbonate: a titrimetric method for determinationClinical Biochemistry, 1973
- SIMULTANEOUS TITRIMETRIC DETERMINATION OF BICARBONATE AND TITRATABLE ACID OF URINEImmunology & Cell Biology, 1967