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Permanent URL to this publication: http://dx.doi.org/10.5167/uzh-63495

Starke, Astrid; Corsenca, Alf; Kohler, Thomas; Knubben, Johannes; Kraenzlin, Marius E; Uebelhart, Daniel; Wüthrich, Rudolf P; von Rechenberg, Brigitte; Müller, Ralph; Ambühl, Patrice M (2012). Correction of metabolic acidosis with potassium citrate in renal transplant patients and its effect on bone quality. Clinical Journal of the American Society of Nephrology, 7(9):1461-1472.

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Abstract

BACKGROUND: Acidosis and transplantation are associated with increased risk of bone disturbances. This study aimed to assess bone morphology and metabolism in acidotic patients with a renal graft, and to ameliorate bone characteristics by restoration of acid/base homeostasis with potassium citrate. METHODS: This was a 12-month controlled, randomized, interventional trial that included 30 renal transplant patients with metabolic acidosis (S-[HCO(3)(-)] <24 mmol/L) undergoing treatment with either potassium citrate to maintain S-[HCO(3)(-)] >24 mmol/L, or potassium chloride (control group). Iliac crest bone biopsies and dual-energy X-ray absorptiometry were performed at baseline and after 12 months of treatment. Bone biopsies were analyzed by in vitro micro-computed tomography and histomorphometry, including tetracycline double labeling. Serum biomarkers of bone turnover were measured at baseline and study end. Twenty-three healthy participants with normal kidney function comprised the reference group. RESULTS: Administration of potassium citrate resulted in persisting normalization of S-[HCO(3)(-)] versus potassium chloride. At 12 months, bone surface, connectivity density, cortical thickness, and cortical porosity were better preserved with potassium citrate than with potassium chloride, respectively. Serological biomarkers and bone tetracycline labeling indicate higher bone turnover with potassium citrate versus potassium chloride. In contrast, no relevant changes in bone mineral density were detected by dual-energy X-ray absorptiometry. CONCLUSIONS: Treatment with potassium citrate in renal transplant patients is efficient and well tolerated for correction of metabolic acidosis and may be associated with improvement in bone quality. This study is limited by the heterogeneity of the investigated population with regard to age, sex, and transplant vintage.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Nephrology
05 Vetsuisse Faculty > Veterinary Clinic > Equine Department > Equine Clinic
05 Vetsuisse Faculty > Center for Applied Biotechnology and Molecular Medicine
DDC:570 Life sciences; biology
610 Medicine & health
630 Agriculture
Language:English
Date:5 July 2012
Deposited On:19 Jul 2012 06:45
Last Modified:30 Nov 2013 07:55
Publisher:American Society of Nephrology
ISSN:1555-9041
Publisher DOI:10.2215/CJN.01100112
PubMed ID:22773591

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