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Improve Bones and Blood Pressure with Potassium Citrate

Potassium citrate might help reverse the negative effect of the high-protein Western diet on bone health while also lowering blood pressure.

Chronic metabolic acidosis has long been suspected to decrease bone mass. The authors of this study hypothesized that the high-protein acidogenic Western diet contributes to the pathophysiology of osteoporosis and that dietary supplementation with alkali in the form of potassium citrate (Kcitrate) might slow the osteoporotic process. To examine this hypothesis, they randomized 161 Swiss postmenopausal women who had low bone mass and had not received any osteoporosis treatment to receive 30 mEq per day of either Kcitrate or potassium chloride (KCl; control) for 12 months. Both groups also received calcium (500 mg/day) and vitamin D (400 IU/day).

Lumbar spine BMD increased progressively and significantly in the Kcitrate group but decreased in the KCl group, yielding an intergroup difference of 1.87% (P<0.001) at 12 months. Interestingly, the Kcitrate group also showed a decrease from baseline in systolic and diastolic BP of 7.9±1.8 mm Hg and 6.4±1.1 mm Hg, respectively. The KCl group showed a similar but slightly smaller drop in BP.

Comment: The increase in net lumbar spine BMD observed by these authors is similar to that reported for raloxifene (see N Engl J Med 1997; 337:1641) but less than that reported for ibandronate (see Bone 1996; 19:527). However, the BP reductions are the first to be reported in long-term K-supplemented, normotensive individuals. Despite some weaknesses (no controls for diet, calcium intake, or exercise, and little ethnic or racial diversity), the study poses an interesting proposition: Simple, inexpensive supplementation with Kcitrate might reverse the negative effect of the high-protein Western diet on bone health while also improving BP. This strategy certainly deserves further study.

— Wendy S. Biggs, MD

Published in Journal Watch Women's Health January 11, 2007

Citation(s):

Jehle S et al. Partial neutralization of the acidogenic Western diet with potassium citrate increases bone mass in postmenopausal women with osteopenia. J Am Soc Nephrol 2006 Nov; 17:3213-22.

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