Potassium-magnesium citrate versus potassium chloride in thiazide-induced hypokalemia.

Abstract

BACKGROUND:

The purpose of this study was to compare the value of potassium-magnesium citrate (KMgCit) with potassium chloride in overcoming thiazide-induced hypokalemia.

METHODS:

Sixty normal subjects first took hydrochlorothiazide (HCTZ; 50 mg/day). After three weeks of treatment (or earlier if hypokalemia developed), they were randomized to take KMgCit (42 mEq K, 21 mEq Mg, and 63 mEq citrate/day) or potassium chloride (42 mEq/day) for three weeks while continuing on HCTZ.

RESULTS:

KMgCit significantly increased the serum potassium concentration from 3.42 +/- 0.30 mEq/L on HCTZ alone to about 3.8 mEq/L (P < 0.001). Potassium chloride produced a similar increase in serum potassium concentration from 3.45 +/- 0.44 mEq/L to about 3.8 mEq/L (P < 0. 001). KMgCit significantly increased the serum magnesium concentration by 0.11 to 0.12 mEq/L (P < 0.01), whereas potassium chloride produced a marginal decline or no significant change. KMgCit was less effective than potassium chloride in correcting HCTZ-induced hypochloridemia and hyperbicarbonatemia. KMgCit, but not potassium chloride, significantly increased urinary pH (by about 0.6 unit), citrate (by about 260 mg/day), and urinary magnesium.

CONCLUSIONS:

KMgCit is equally effective as potassium chloride in correcting thiazide-induced hypokalemia. In addition, KMgCit, but not potassium chloride, produces a small but significant increase in serum magnesium concentration by delivering a magnesium load, and it confers alkalinizing and citraturic actions.

• Authors: L A Wuermser, C Reilly, J R Poindexter, K Sakhaee, C Y Pak
• Journal: Kidney international (Kidney Int) Vol. 57 Issue 2 Pg. 607-12 (Feb 2000) ISSN: 0085-2538 [Print] United States
• PMID: 10652038 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S.)

Chemical References

• Citrates
• Diuretics
• Drug Combinations
• Magnesium Compounds
• Potassium Compounds
• Sodium Chloride Symporter Inhibitors
• Hydrochlorothiazide
• Potassium Chloride
• Magnesium
• potassium-magnesium citrate

Topics

• Adult
• Citrates (administration & dosage, adverse effects, urine)
• Diuretics
• Double-Blind Method
• Drug Combinations
• Female
• Humans
• Hydrochlorothiazide (adverse effects)
• Hydrogen-Ion Concentration
• Hypokalemia (chemically induced, drug therapy, urine)
• Kidney Calculi (chemically induced)
• Magnesium (blood)
• Magnesium Compounds (administration & dosage, adverse effects)
• Male
• Middle Aged
• Potassium Chloride (administration & dosage, adverse effects)
• Potassium Compounds (administration & dosage, adverse effects)
• Sodium Chloride Symporter Inhibitors (adverse effects)