Regulating Urine pH Levels to Alleviate Chronic Joint Pain

Summary

This study aims to determine the causal relationship between regulating urine pH levels between 7.0 and 7.5 and decreasing chronic joint pain. The investigators hypothesize that maintenance of an alkaline urinary pH will result in a decrease in personally reported levels of chronic joint pain using a citrate treatment regimen.

Timeline

Start

2011-07

Primary completion

2012-03

Completion

2012-03

Publications

• Background Schaible HG, Richter F, Ebersberger A, Boettger MK, Vanegas H, Natura G, Vazquez E, Segond von Banchet G. Joint pain. Exp Brain Res. 2009 Jun;196(1):153-62. doi: 10.1007/s00221-009-1782-9. Epub 2009 Apr 11.
• Background Goldring MB, Goldring SR. Osteoarthritis. J Cell Physiol. 2007 Dec;213(3):626-34. doi: 10.1002/jcp.21258.
• Background Devchand PR, Keller H, Peters JM, Vazquez M, Gonzalez FJ, Wahli W. The PPARalpha-leukotriene B4 pathway to inflammation control. Nature. 1996 Nov 7;384(6604):39-43. doi: 10.1038/384039a0.
• Background Gurol et al, US Patent 2007/0218126 A1. Compositions and methods for reducing inflammation and pain associated with acidosis (7p.).
• Background Sterrett SP, Penniston KL, Wolf JS Jr, Nakada SY. Acetazolamide is an effective adjunct for urinary alkalization in patients with uric acid and cystine stone formation recalcitrant to potassium citrate. Urology. 2008 Aug;72(2):278-81. doi: 10.1016/j.urology.2008.04.003. Epub 2008 Jun 4.
• Background Pizzorno J, Frassetto LA, Katzinger J. Diet-induced acidosis: is it real and clinically relevant? Br J Nutr. 2010 Apr;103(8):1185-94. doi: 10.1017/S0007114509993047. Epub 2009 Dec 15.
• Background Kiwull-Schone H, Kiwull P, Manz F, Kalhoff H. Food composition and acid-base balance: alimentary alkali depletion and acid load in herbivores. J Nutr. 2008 Feb;138(2):431S-434S. doi: 10.1093/jn/138.2.431S.
• Background Kanbara A, Hakoda M, Seyama I. Urine alkalization facilitates uric acid excretion. Nutr J. 2010 Oct 19;9:45. doi: 10.1186/1475-2891-9-45.
• Background Welch AA, Mulligan A, Bingham SA, Khaw KT. Urine pH is an indicator of dietary acid-base load, fruit and vegetables and meat intakes: results from the European Prospective Investigation into Cancer and Nutrition (EPIC)-Norfolk population study. Br J Nutr. 2008 Jun;99(6):1335-43. doi: 10.1017/S0007114507862350. Epub 2007 Nov 28.
• Background Medzhitov R. Origin and physiological roles of inflammation. Nature. 2008 Jul 24;454(7203):428-35. doi: 10.1038/nature07201.
• Background Basbaum AI, Bautista DM, Scherrer G, Julius D. Cellular and molecular mechanisms of pain. Cell. 2009 Oct 16;139(2):267-84. doi: 10.1016/j.cell.2009.09.028.
• Background Aras B, Kalfazade N, Tugcu V, Kemahli E, Ozbay B, Polat H, Tasci AI. Can lemon juice be an alternative to potassium citrate in the treatment of urinary calcium stones in patients with hypocitraturia? A prospective randomized study. Urol Res. 2008 Dec;36(6):313-7. doi: 10.1007/s00240-008-0152-6. Epub 2008 Oct 23.
• Background McNally MA, Pyzik PL, Rubenstein JE, Hamdy RF, Kossoff EH. Empiric use of potassium citrate reduces kidney-stone incidence with the ketogenic diet. Pediatrics. 2009 Aug;124(2):e300-4. doi: 10.1542/peds.2009-0217. Epub 2009 Jul 13.
• Background Whitson PA, Pietrzyk RA, Jones JA, Nelman-Gonzalez M, Hudson EK, Sams CF. Effect of potassium citrate therapy on the risk of renal stone formation during spaceflight. J Urol. 2009 Nov;182(5):2490-6. doi: 10.1016/j.juro.2009.07.010. Epub 2009 Sep 17.
• Background Spivacow FR, Negri AL, Polonsky A, Del Valle EE. Long-term treatment of renal lithiasis with potassium citrate. Urology. 2010 Dec;76(6):1346-9. doi: 10.1016/j.urology.2010.02.029.
• Background Iakovenko EP, Agafonova NA, Pokhal'skaia OIu, Kolganova AV, Nazarbekova RS, Ivanov AN, Davletshina IV, Popova EV, Prianishnikova AS, Ovchinnikova NI, Iakovenko AV, Aldiiarova MA, D'iachkoava AV, Gioeva IZ. [The use of bismuth tripotassium dicitrate (De-Nol), a promising line of pathogenetic therapy for irritated bowel syndrome with diarrhea]. Klin Med (Mosk). 2008;86(10):47-52. Russian.
• Background Balkowiec-Iskra E. [The role of immune system in inflammatory pain pathophysiology]. Pol Merkur Lekarski. 2010 Dec;29(174):395-9. Polish.

Drugs

Indications