Does disodium hydrogen citrate (Citrate) syrup cause hyperosmolar urine?

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Last updated: February 11, 2025 • View editorial policy

From the Research

Urinary Citrate and Hyperosmolar Urine

  • The relationship between disodium hydrogen citrate (Citrate) syrup and hyperosmolar urine is not directly addressed in the provided studies 1, 2, 3, 4, 5.
  • However, the studies discuss the role of citrate in urinary stone disease and its effects on urinary chemistries.
  • Citrate is known to be an important inhibitor of calcium oxalate and calcium phosphate stone formation, and its excretion is influenced by various factors, including acid-base status and potassium intake 2, 3, 5.
  • The use of alkali citrate treatment, such as potassium citrate or sodium citrate, can increase urinary citrate excretion and reduce the risk of stone recurrence 2, 3, 5.
  • However, the effects of citrate on urinary osmolality are not explicitly mentioned in the studies.

Citrate and Urinary pH

  • Some studies suggest that urinary citrate levels do not correlate with urinary pH in patients with urinary stone formation 4.
  • In one study, no correlation was found between urinary citrate and pH levels in a cohort of patients with urinary stone formation 4.
  • Another study found that sodium citrate therapy increased urinary citrate substantially, but did not significantly decrease urinary calcium, and the urinary environment became supersaturated with respect to brushite and monosodium urate 3.

Conclusion on Available Evidence

  • There is no direct evidence in the provided studies to suggest that disodium hydrogen citrate (Citrate) syrup causes hyperosmolar urine.
  • The studies primarily focus on the role of citrate in urinary stone disease and its effects on urinary chemistries, rather than its impact on urinary osmolality.

References

Research

Urinary citrate and renal stone disease: the preventive role of alkali citrate treatment.

Archivio italiano di urologia, andrologia : organo ufficiale [di] Societa italiana di ecografia urologica e nefrologica, 2009

Research

Urine citrate and renal stone disease.

CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 1989

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