In our “Ask a kidney stone doctor” section, we field questions from stone formers or their family members. Today’s question is about long-term use of potassium citrate. See other questions and answers or ask your own question here.
October 11, 2011
Question from a stone former in the UK:
Does chronic use of Potassium Citrate (to keep the pH alkaline) have any long term drawbacks?
Long term potassium citrate therapy is generally well tolerated and safe but can carry some potential side effects and risks. Some patients may experience gastrointestinal upset with the medication. Taking it with meals can help alleviate this. There also appears to be conflicting evidence about whether potassium citrate can increase the risk of calcium phosphate stones by causing the urine to be too alkaline. If there is an increased risk of calcium phosphate stones, it appears to be small. Finally, potassium citrate therapy can cause an abnormally high blood potassium level in certain situations. According to the manufacturer of Urocit-K, “Conditions that may put you at risk include kidney failure, uncontrolled diabetes, severe dehydration, strenuous physical exercise if you’re unconditioned, extensive tissue breakdown, or adrenal insufficiency”.
References: Campbell-Walsh Urology, 10th ed. and Mission Pharmacal prescribing information