Synopsis

Source of validity: Scientific
Rating (out of 5): 4

Potassium, particularly in the form of potassium citrate, is scientifically validated for use in the prevention and management of certain types of kidney stones, most notably calcium oxalate and uric acid stones. The rationale for potassium citrate therapy is based on its ability to alkalinize urine and increase urinary citrate levels. Citrate is a natural inhibitor of stone formation in the urinary tract; it binds with calcium, reducing the amount of free calcium available to form stones and also inhibits the aggregation of crystals that can lead to stone development.

Multiple randomized controlled trials and clinical guidelines support the use of potassium citrate for patients with hypocitraturia (low urinary citrate) and recurrent kidney stones. Studies have shown that potassium citrate supplementation can significantly decrease stone recurrence rates compared to placebo, with benefits evident both in adults and children. The American Urological Association and the European Association of Urology include potassium citrate as a recommended therapy for patients with calcium stones who have low urinary citrate. Potassium chloride, in contrast, does not have the same effect since it does not provide the citrate anion.

While potassium supplementation is not appropriate for all types of kidney stones (and may be contraindicated in patients with certain medical conditions, such as chronic kidney disease or those taking potassium-sparing diuretics), its use in selected cases is well established and evidence-based. Potassium citrate is available in prescription and over-the-counter formulations, and its dosing and monitoring should be guided by a healthcare professional.

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