Alkali citrate (also known as alkaline citrate) is an inhibitor of Kidney Stones. It is used to increase urine citrate levels - this prevents calcium oxalate stones by binding to calcium and inhibiting its binding to oxalate. It is also used to increase urine pH (alkalinize urine) - this prevents uric acid stones and cystine stones (which form in cystinuria).
It is different from citric acid which is citrate bonded by hydrogen ions (or protons) making it acidic. Citric acid does not alkalinize urine as alkali citrate does. Alkali citrate replaces the protons with a non-acid positively charged ion like sodium, potassium or magnesium.
Citrus based beverages like lemon juice and orange juice may raise urine citrate, but much of the citrate is citric acid; without a cation like sodium, potassium or magnesium these beverages will have less effect on urine chemistry and therefore not aid in prevention of kidney stones as alkali citrate will.
Oral alkali supplementation can also slow the rate of kidney function decline and "potentially reduce the risk of end stage kidney disease (ESKD) in patients with chronic kidney disease (CKD) and metabolic acidosis."
The compound also raises urine pH. When citrate is metabolized by the liver, it essentially generates bicarbonate, an important buffer. This reduces uric acid supersaturation and prevents uric acid stones and .
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