Correspondence

Improved Mineral Balance and Skeletal Metabolism in Postmenopausal Women Treated with Potassium Bicarbonate

N Engl J Med 1994; 331:279July 28, 1994

Article

To the Editor:

In regard to our article on improved mineral balance and skeletal metabolism in postmenopausal women given potassium bicarbonate (June 23 issue),1 some concern has been expressed about the risk of hyperkalemia with the doses used (60 to 120 mmol of potassium bicarbonate per 60 kg of body weight per day), particularly in older subjects whose renal function may have declined as part of aging.

We would like to emphasize that pending the results of long-term studies (lasting years), the findings in our short-term study (which lasted for only days) provide no basis for recommending potassium bicarbonate in any dose for the prevention or treatment of osteoporosis. At present, for protection against the potentially deleterious long-term skeletal effects of diet-related acid production, we recommend modifying the diet, specifically to reduce precursors of dietary acid (e.g., by eating less animal protein) and increase dietary base (e.g., by eating more vegetables and fruits).

If the long-term administration of potassium bicarbonate proves to be bone-sparing, physicians who choose to prescribe it will need to screen their patients for factors, including the use of medications, that predispose them to hyperkalemia.

Anthony Sebastian, M.D.
R. Curtis Morris, Jr., M.D.
University of California, San Francisco, San Francisco, CA 94143

1 References

1. 1

   Sebastian A, Harris ST, Ottaway JH, Todd KM, Morris RC Jr. Improved mineral balance and skeletal metabolism in postmenopausal women treated with potassium bicarbonate. N Engl J Med 1994;330:1776-1781
   Full Text | Web of Science | Medline

Citing Articles (7)

Citing Articles

1. 1

   Susan S. Harris, Bess Dawson-Hughes. (2010) No effect of bicarbonate treatment on insulin sensitivity and glucose control in non-diabetic older adults. Endocrine 38:2, 221-226
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2. 2

   Lynda Frassetto, Shoma Berkemeyer. 2009. Osteoporosis. .
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3. 3

   K. Zhu, A. Devine, R. L. Prince. (2009) The effects of high potassium consumption on bone mineral density in a prospective cohort study of elderly postmenopausal women. Osteoporosis International 20:2, 335-340
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4. 4

   Frank R. DUNSHEA, Maree L. COX. (2008) Effect of dietary protein on body composition and insulin resistance using a pig model of the child and adolescent. Nutrition & Dietetics 65, S60-S65
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5. 5

   Dincer Yildizdas, A. Kemal Topaloglu, Neslihan O. Mungan, Bilgin Yuksel, Guler Ozer. (2004) Bone Mineral Changes in Acute Metabolic Acidosis due to Acute Gastroenteritis. Calcified Tissue International 75:5, 380-383
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6. 6

   René Rizzoli, Jean-Philippe Bonjour. (2004) Dietary Protein and Bone Health. Journal of Bone and Mineral Research 19:4, 527-531
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7. 7

   Hubert K Zajicek, Huamin Wang, Krishna Puttaparthi, Nabil Halaihel, Daniel Markovich, James Shayman, Richard Béliveau, Paul Wilson, Thomas Rogers, Moshe Levi. (2001) Glycosphingolipids modulate renal phosphate transport in potassium deficiency. Kidney International 60:2, 694-704
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