Over-the-Counter Alkali Agents to Raise Urine pH and Citrate Excretion: A Prospective Crossover Study in Healthy Adults

Noah E. Canvasser, Marcelino Rivera, Seth K. Bechis, Johann Ingimarsson, John Knoedler, Karen Stern, Christa L. Stoughton, Daniel Wollin, Michael Borofsky, Naeem Bhojani, Marawan El Tayeb, Guido Kamphuis, David Leavitt, Ryan S. Hsi, Kymora B. Scotland

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


Objective: To assess the effect of 2 over-the-counter alkalizing agents on 24 hour urinary parameters. Materials and Methods: Ten healthy volunteers without a history of kidney stones were recruited to complete a baseline 24 hour urinalysis with a 4 day diet inventory. Participants then maintained the same diet on either LithoLyte (20 mEq 2 times per day) or KSPtabs (1 tablet 2 times per day) and submitted another 24 hour urinalysis. The process was repeated with the other supplement. Urinary alkali parameters were compared to baseline, and side effects were elicited with a questionnaire. Results: LithoLyte intake resulted in a non-significant increase in citrate (597-758 mg/day, P =.058, an increase in urine pH (6.46-6.66, P =.028), and a decrease in urine ammonium (41-36 mmol/day, P =.005) compared to baseline. KSPtabs resulted in an increase in citrate (597-797 mg/day, P =.037) and urine pH (6.46-6.86, P =.037), with a non-significant decrease in ammonium (41-34 mmol/day, P =.059). No significant differences were seen comparing urinary analytes between LithoLyte and KSPtabs. With Litholyte, no side effects, mild, moderate, and severe side effects were seen in 50%, 40%, 10%, and 0%, respectively. With KSPtabs, rates were 60%, 20%, 10%, and 10%, respectively. Conclusion: In healthy participants without a history of kidney stones, LithoLyte and KSPtabs are effective over-the-counter alkali supplements, with a similar side effect profile to prescription potassium citrate.

Original languageEnglish (US)
Pages (from-to)72-78
Number of pages7
StatePublished - Oct 2022

Bibliographical note

Funding Information:
Source of funding: This was an investigator-initiated project where the protocol, data collection, statistical analysis and drafting of the manuscript was performed by the authors. The study supplements, Litholyte and KSPtabs, and 24 hour urine testing were funded by the manufacturers.

Publisher Copyright:
© 2022 Elsevier Inc.

PubMed: MeSH publication types

  • Journal Article
  • Research Support, Non-U.S. Gov't


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