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Randomized Controlled Trial
. 2015 Nov;30(11):2103-11.
doi: 10.1002/jbmr.2554. Epub 2015 Jul 28.

Potassium Bicarbonate Supplementation Lowers Bone Turnover and Calcium Excretion in Older Men and Women: A Randomized Dose-Finding Trial

Bess Dawson-Hughes  1 , Susan S Harris  1 , Nancy J Palermo  1 , Cheryl H Gilhooly  1 , M Kyla Shea  1 , Roger A Fielding  1 , Lisa Ceglia  1
Affiliations
Randomized Controlled Trial

Potassium Bicarbonate Supplementation Lowers Bone Turnover and Calcium Excretion in Older Men and Women: A Randomized Dose-Finding Trial

Bess Dawson-Hughes et al. J Bone Miner Res. 2015 Nov.

Abstract

The acid load accompanying modern diets may have adverse effects on bone and muscle metabolism. Treatment with alkaline salts of potassium can neutralize the acid load, but the optimal amount of alkali is not established. Our objective was to determine the effectiveness of two doses of potassium bicarbonate (KHCO3 ) compared with placebo on biochemical markers of bone turnover, and calcium and nitrogen (N) excretion. In this double-blind, randomized, placebo-controlled study, 244 men and women age 50 years and older were randomized to placebo or 1 mmol/kg or 1.5 mmol/kg of KHCO3 daily for 3 months; 233 completed the study. The primary outcomes were changes in 24-hour urinary N-telopeptide (NTX) and N; changes in these measures were compared across the treatment groups. Exploratory outcomes included 24-hour urinary calcium excretion, serum amino-terminal propeptide of type I procollagen (P1NP), and muscle strength and function assessments. The median administered doses in the low-dose and high-dose groups were 81 mmol/day and 122 mmol/day, respectively. When compared with placebo, urinary NTX declined significantly in the low-dose group (p = 0.012, after adjustment for baseline NTX, gender, and change in urine creatinine) and serum P1NP declined significantly in the low-dose group (p = 0.004, adjusted for baseline P1NP and gender). Urinary calcium declined significantly in both KHCO3 groups versus placebo (p < 0.001, adjusted for baseline urinary calcium, gender, and changes in urine creatinine and calcium intake). There was no significant effect of either dose of KHCO3 on urinary N excretion or on the physical strength and function measures. KHCO3 has favorable effects on bone turnover and calcium excretion and the lower dose appears to be the more effective dose. Long-term trials to assess the effect of alkali on bone mass and fracture risk are needed.

Keywords: ACID-BASE; BICARBONATE; BONE; OSTEOPOROSIS; POTASSIUM.

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Conflict of interest statement

Disclosures

All authors state that they have no conflicts of interest.

Figures

Fig. 1
Fig. 1
Adjusted mean 84-day changes in urinary calcium, NTX, and NAE and serum P1NP. For adjustments, see Table 3. *Differs from placebo at p < 0.001. +Differs from placebo at p =0.036. #Differs from placebo at p =0.011.
Fig. 2
Fig. 2
Mean urinary calcium, NTX, and P1NP by category of NAE at the end of the study.
See this image and copyright information in PMC

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