The Journal of Urology
Volume 182, Issue 5 , Pages 2490-2496, November 2009

Effect of Potassium Citrate Therapy on the Risk of Renal Stone Formation During Spaceflight

  • Peggy A. Whitson

      Affiliations

    • Astronaut Office, National Aeronautics and Space Administration Johnson Space Center, Houston, Texas
    • ,
  • Robert A. Pietrzyk

      Affiliations

    • Human Adaptation and Countermeasures Division, Wyle Integrated Science and Engineering Group, Houston, Texas
    • Corresponding Author InformationCorrespondence: Wyle Integrated Science and Engineering Group, 1290 Hercules Dr., Suite 120, Houston, Texas 77058 (telephone: 281-483-8078; FAX: 281-483-2888)
    • ,
  • Jeffrey A. Jones

      Affiliations

    • Space Medicine Division, National Aeronautics and Space Administration Johnson Space Center, Houston, Texas
    • ,
  • Mayra Nelman-Gonzalez

      Affiliations

    • Human Adaptation and Countermeasures Division, Wyle Integrated Science and Engineering Group, Houston, Texas
    • ,
  • Edgar K. Hudson

      Affiliations

    • JES Tech, Houston, Texas
    • ,
  • Clarence F. Sams

      Affiliations

    • Human Adaptation and Countermeasures Division, National Aeronautics and Space Administration Johnson Space Center, Houston, Texas

Received 23 February 2009 published online 17 September 2009.

Purpose

Exposure to microgravity affects human physiology and results in changes in urinary chemical composition during and after spaceflight, favoring an increased risk of renal stones. We assessed the efficacy of potassium citrate to decrease the stone risk during and after spaceflight.

Materials and Methods

The study was done in 30 long duration spaceflight crew members to the space stations Mir and International Space Station. Before, during and after spaceflight 24-hour urine samples were collected to assess the renal stone risk. Potassium citrate (20 mEq) was ingested daily by International Space Station crew members in a double-blind, placebo controlled study. Mir crew members performed the identical protocol but did not ingest medication.

Results

Potassium citrate treated crew members had decreased urinary calcium excretion and maintained the calcium oxalate supersaturation risk at preflight levels compared to that in controls. Increased urinary pH in the treatment group decreased the risk of uric acid stones.

Conclusions

Results from this investigation suggest that supplementation with potassium citrate may decrease the risk of renal stone formation during and immediately after spaceflight.

Key Words: kidney, kidney calculi, space flight, potassium citrate, uric acid

Abbreviations and Acronyms: CAOX, calcium oxalate, ISS, International Space Station, JSC, Johnson Space Center, KCIT, potassium citrate, NASA, National Aeronautics and Space Administration, R+0–2, first 3 days after landing, R+7, 7 days after landing

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 Study received approval from the NASA Johnson Space Center Committee for the Protection of Human Subjects, Russian Bioethics Board, European Medical Board and Human Research Multilateral Review Board.

 Supported by National Aeronautics and Space Administration 96-OLMSA-01.

PII: S0022-5347(09)01734-0

doi:10.1016/j.juro.2009.07.010

The Journal of Urology
Volume 182, Issue 5 , Pages 2490-2496, November 2009

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