November 21, 2012
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Potassium citrate improved BMD in elderly patients on vitamin D, calcium

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When administered potassium citrate in a background of vitamin D and calcium supplements, elderly patients with normal bone mass experienced improvements in bone mineral density and bone microarchitecture, according to study data published in the Journal of Clinical Endocrinology & Metabolism.

Researchers sought to examine whether alkali intervention could prevent the age-associated decline of bone mass and bone architecture in elderly patients by using two independent bone imaging methods: DXA and high-resolution peripheral quantitative CT (HR-pQCT).

Sigrid Jehle, MD, of the University of Basel in Switzerland, and colleagues conducted a randomized, double blind, placebo-controlled trial on 201 patients aged older than 65 years. Although all patients received calcium and vitamin D supplementation, an intervention group was administered oral potassium citrate 60 mEq daily (n=101) and the nontreatment group received placebo (n=100).

“There was a significant increase in serum 25-hydroxyvitamin D and a subsequent significant decrease in serum [parathyroid hormone] concentration in both arms, attributable to the vitamin D supplement. There were small, but significant increases in the [insulin-like growth factor I] serum concentration in both groups, but no intergroup differences,” the researchers wrote.

According to data, potassium citrate increased areal BMD at lumbar spine from baseline by 1.7% (95% CI, 1-2.3) compared with placebo after 24 months. Additionally, the HR-pQCT measured trabecular densities, which increased by 1.3% (95% CI, 0.7-1.9) at nondominant tibia and 2% (95% CI, 1.4-2.7) at nondominant radius.

Regarding nondominant radius, trabecular bone volume or tissue volume also increased by 0.9% (95% CI, 0.1-1.7), trabecular thickness by 1.5% (95% CI, 0.7-2.3) and trabecular number by 1.9% (95% CI, 0.7-3.1).

Furthermore, potassium citrate administration tended to decrease the fracture prediction score, as measured by FRAX, significantly in men and women.

Jehle and colleagues concluded that potassium citrate administered to healthy, elderly patients with normal bone mass who were also taking vitamin D and calcium supplements was well tolerated and an inexpensive intervention to increase areal BMD and trabecular volumetric BMD, besides improving bone microarchitecture.

Disclosure: The researchers report no relevant financial disclosures.