| 2010 scientific study with control participants, that shows alkalinity slows down kidney failure.
We are grateful to have available to us, the detailed potassium citrate clinical research undertaken by these dedicated scientists - Judy Tanner and George Tanner. It is through their work that we with PKD have come to learn the benefits of remaining alkaline. The Tanners performed some very precise detailed experiments that led to the discovery of potassium alone helped PKD and citrate alone helped PKD, but by far and away the most benefit was obtained from alkalinity. Citrate is utilized by the kidneys as energy. Sodium citrate and potassium citrate were equally effective alkalizers. Calcium citrate was less so. In the normal progression of PKD towards end stage renal disease, potassium rises. Many doctors oftentimes prescribe a favorite old standby, sodium bicarb, as an inexpensive alkalizer. However due to the inherent nature of PKD, this will lead to an increase in kidney stone formation, especially for PKD'rs. We already have a 20% increased risk of developing kidney stones. Taking sodium bicarbonate multiplies this risk. Ask your nephrologist if sodium citrate might prove beneficial for you.
Not only is potassium citrate or alkalinity beneficial for PKD, there are some clinical trials that show it also helps lower blood pressure and improve bone density and diminish recurrent kidney stone formation. Select from the pull down menu of articles.
Potassium citrate improves renal function in PKD rats 1998
Potassium citrate is a very effective alkalizer. This is the paper that started it all, the first publication on the effectiveness of potassium citrate in PKD. Sodium citrate is as effective as potassium citrate. Calcium citrate is less so. The animals given potassium citrate lived 17 months as opposed to their counterparts who lived 10 months. Animals fed potassium citrate had smaller cystic kidneys and lived almost twice as long. Thanks to the continued work of these PKD researchers, taking potassium citrate is now recognized as a possible means of decreasing cystic kidney size resulting in improved kidney function. It is an exclusion for participating in Tolvaptan clinical trials as it has been noted there is some evidence that it could help diminish kidney cysts.
Citrate therapy for PKD in rats. 2000
Citrate salts that have an alkalinizing effect preserve kidney functioning and extend survival. Potassium helps. Citrate helps. But it is alkalinity that really helps to keep cystic kidneys functioning.
Dietary citrate treatment of PKD in rats 2003
The earlier an alkalizing diet is begun, the better for PKD'rs.
Dietary potassium citrate does not harm the pcy mouse. 2005
No species of the PKD model was harmed by potassium citrate. Potassium citrate in the feed does not affect the progression of renal cystic disease in the pcy mouse. This model closely resembles human adolescent nephronophthisis. Potassium citrate has been used for years to effectively treat kidney stones There are no literature reports of adverse reactions from taking monitored potassium citrate.
George Tanner Bio
George Tanner retired 2009. Read more POTASSIUM CITRATE ARTICLES
Finally a 2010 scientific study with control participants, that shows alkalinity slows down kidney failure.
A growing number of questions regarding the ability of potassium citrate to delay dialysis, diminish cyst growth, maintain kidney health and avert organ transplant have been asked. If true, potassium citrate would be a real lifesaver. Inexpensive potassium citrate is a much more viable alternative to costly dialysis and delicate organ transplantation. Recent articles from Asia point to alkalizers (i. e. potassium citrate) coupled with an alkaline neutral protein diet (avoiding all animal foods) as having decreased proteinuria by 90%. In poorer countries, this discovery is of such a great value. The cost of sophisticated treatments are way beyond the reach of most of its citizens. In many of the less prosperous nations, the daily struggle involves obtaining enough food to nourish the body rather than directed toward keeping the body healthy. There is a food that is both alkaline and available in many of these countries. It can be easily cultivated. It is drumstick, Malungai or moringa oleifera. The leaves can be made into a soup. The vegetable fruit from the tree is called drumstick. It is high in amino acids, iron, potassium, beneficial for the kidneys and liver and could be one answer to a food source for improvised nations. It has many uses among them water purification, protection against cardiac damage, protection from liver damage and diabetes.
A news article Saving Failing Kidneys from the Malaysian Star shows the efficacy of a very low low protein diet, avoiding all animal proteins and this has been playing a dramatic role in keeping diseased kidneys healthy. I am pleased to see the origin of this article is in Malaysia where dialysis and transplant are economically unfeasible for many with failing kidneys. There seems to now be another way to help keep cystic kidneys healthy.
Have your serum potassium checked before changing anything your diet and have your doctor monitor your serum potassium regularly. With PKD polycystic kidney disease, sometimes our potassium can rise from our cystic kidneys malfunctioning. Potassium is an essential mineral that we get from many common foods. True potassium deficiencies are rare except in cases of prolonged vomiting or diarrhea, or with the use of diuretic drugs.
In one sense, potassium deficiency is common, at least when compared to the amount of sodium we receive in our diets. It is probably healthy to take in at least five times as much potassium as sodium (and perhaps 50 to 100 times as much). But the standard American diet contains twice as much sodium as potassium. Therefore, taking extra potassium may be a good idea in order to balance the sodium we consume to such excess. Some food sources of potassium are: bananas, orange juice, avocados, lima beans, cantaloupes, peaches, flounder, and cod all contain more than 300 mg of potassium per serving. Other good sources include various fruits and vegetables. Over-the-counter potassium supplements typically contain 99 mg of potassium per tablet. There is some evidence that, of the different forms of potassium supplements, potassium citrate may be most helpful for those with high blood pressure. Some research indicates that it is important to get enough magnesium, too, when you are taking potassium. It might be wise to take extra vitamin B12 as well. Check with your doctor before trying any changes.
HOW TO TAKE POTASSIUM CITRATE OR SODIUM CITRATE?
Potassium citrate needs to be prescribed by your physician. Prior to starting supplemental potassium citrate, have a urinary citrate level taken and if low (as is to be expected with PKD), then your doctor might be willing to prescribe Potassium Citrate for you. Start slowly, perhaps a teaspoon (Polycitra syrup) or 10 mEq of the tablets. If ones nightly urinary pH tested 7.0 or higher about 7.2, this is ideal.
If the nitrazine paper pH turned pale green or yellow, some doctors suggest taking a teaspoon of polycitra syrup or 1 tablet. A urinary pH of 6.0 is good; however 7.2 (blue) is better.
Test urinary pH at night just before bed. When prescribed for me in this fashion, I rarely had to take any potassium citrate except when I was undergoing something particularly stressful, or if I got an infection, or even if I had my teeth cleaned, or if I had to take any medication. My nephrologist prescribed urocit K or polycitra syrup.
I take it to supplement my alkaline diet whenever my urinary pH (I test this with pH strips) drops below 7.0. Initially I took polycitra syrup 1 teaspoon while testing my urinary pH every time. My doctor checked my serum potassium at one week, at one month, then at 3 months then every 6 months and then once a year.
I have learned to recognize the symptoms of potassium overload, hyperkalemia. I get a cramping sensation in my stomach with bloating. Or I might get cramping of my muscles. Or I may not feel very well. I know to go in and get my potassium checked.
Print a PDF file with high and low potassium symptoms.
| High Potassium Symptoms Include: |
| stomach intestinal cramps |
| generalized fatigue |
| weakness |
| paralysis |
| palpitations |
| burning |
| tingling |
| numb feelings |
| mental confusion |
| heart symptoms |
| EKG changes |
TAKING POTASSIUM CITRATE:
Work with your nephrologist.
Lab Work:
Urinary citrate
Check serum potassium level
Prescription for Urocit K or Polycitra syrup or Sodium Citrate
Have a serum potassium as a baseline then once starting prescribed potassium citrate get a potassium level checked twice a week, once a week, once every two weeks, once a month, once every 3 months, once every 6 months and any time you just don't feel well. Urinary pH will not let you know what your potassium, only your relative alkalinity.
Test urinary pH at night just before bed. If it registers 6.5, 7.0, 7.5 do not take any citrate salts.
If someone is a meat eater or does not wish to adjust their diet or has kidney stones then the recommended dose for adults is a tablespoon 4 x a day. If someone notices burning with urination and there is no infection, then supplement with (2) two ounces of cranberry juices diluted in 1 ounce of mineral water. (I do this daily to protect my kidneys) I find the Northland brand cherry cranberry 100% juice to taste best. Get an all juice cranberry juice not a cocktail. If fluids are restricted, than cranberry capsules could be used.
Alkaline Diet
The alkaline diet is what many use to create alkalinity, consisting of fruits, vegetables, and nuts. Try for locally grown or organic when possible and have at least 5-10 different vegetables in any given day. ENJOY many plant based foods such as cabbage, almonds, coconut, chestnuts, spelt, rye, corn, romaine lettuce, cucumbers, broccoli sprouts, radish sprouts,greens, avocado, watercress, Swiss chard, endive, green beans, squash, and many below ground crops such as rutabagas, radish, parsnips, sunchokes, sweet potato, yams, carrots, turnips, burdock root, beetroot, celeriac. aVOID potatoes, celery, iceberg lettuce, strawberries, rhubarb, star fruit, tomatoes, eggplant, nightshade plants, peppers, wheat, white rice, concentrated sugars, soy, edamame, caffeine, chocolate, coffee, tea, colas, soda, fish, meat, dairy, pork, poultry, chicken, turkey, ham, pink meats, hot dogs, pepperoni, hamburgers, cheese, cream, milk, eggs, and most animal products with the exception of egg yolk, broths and soups.
Test urinary pH nightly. As long as it remains above Usually urinary pH is acidic, in the 5.5 range. Though 7.0 is neutral, between 6.5, 7.0, 7.5 is a better urinary pH to maintain cystic kidney health. continue with my diet. If it drops below this for any reason, then with your doctor's help, supplement with potassium citrate or a few drops of high potassium non alcoholic nettle extract, or take an extra serving of cabbage juice with almonds, or a few more freshly squeezed cupfuls of lemon juice, or an ounce of cereal grass juice, or DIMs (diindolymethane - concentrated broccoli sprouts) or freshly squeezed orange juice or grapefruit (careful with grapefruit if you take medications or are on thyroid medications), or any number of other foods that will swing one toward alkaline.
What can change a person toward acid?
Emotions, lack of exercise, stress, are a few that will turn us acidic. This is a PKDiet lifestyle. Couple this diet with walks in beauty or nature or sharing a moment with a loved one or taking a long slow moment to relax or taking an afternoon nap or some activity which helps clear the mind for a very brief second or two, like taking (8) eight long slow deep breathes. Breathing clears any cellular lactic acid build up.
The PKD models that were fed potassium citrate maintained functioning kidneys throughout their lifetime. Their cystic kidneys felt different. Huge cystic kidneys did not develop in the PKD animal model fed potassium citrate.
The protein requirement for someone with PKD before dialysis in 0.6 grams of protein per kilogram of body weight. This is a normal protein diet. It is not a low protein diet. It is the amount of protein, that will create a neutral protein balance. This means it is the amount of protein, which is just the exactly correct amount to take care of all the body's needs. There is no excess and there is no deficit of protein. If ingested proteins are plant based, this is best for our cystic kidneys.
Eventually some of us have a decline in kidney functioning. This is characterized by the inability to concentrate urine and spilling protein in the urine. Some of us also test for urinary proteins. Albustix are useful for this. Alkalinity or potassium citrate also diminishes proteinuria.
What can be done when kidney functioning begins to decline?
There is a French study,, that shows once dialysis begins, supplements of essential amino acids and protein restriction will help to correct a low serum albumin.
This seems to be contrary to the customary practice. It is oftentimes thought that by increasing dietary protein, this will result in an increase in low serum albumin. A low serum albumin is a predictor of a less than optimal outcome. If serum albumin is low, it is best to raise it. Dr. Mackenzie Walser has shown as patients reach end stage renal disease, by restricting dietary protein to 0.3 grams per kilogram of body, maintaining alkalinity and supplementing with essential amino acids of a particular formula for kidney patients, this can result in a rise of a low serum albumin.
This is good news.
It means that anytime we choose to institute alkalinity into our lives, change for the better may be very possible. We can attempt to halt the progression of kidney disease. Dr. Walser's book is Coping with Kidney Disease. Once an individual starts spilling protein in their urine, Dr. Walser drops the protein intake from to 0.3 grams of protein per kilogram of body weight. He has individuals take supplements of essential amino acids in exactly the correct proportions that are needed by the body daily. He uses either Gambro or Calwood brand essential amino acids. He assures that individuals remain alkaline throughout treatment. He restricts animal proteins, high phosphorus foods, high potassium foods, and protein rich vegetables. Some have delayed dialysis for sometimes 3 years, sometimes forever.
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