Sodium Citrate's Side Effects
Sodium citrate is used to treat a condition called metabolic acidosis. In metabolic acidosis, the acidity of the blood, urine and other bodily fluids becomes too high; it occurs when the kidney is excreting too little acid, or the body is producing too much acid. Several types of metabolic acidosis include lactic acidosis, diabetic ketoacidosis and renal tubular acidosis. Treating this condition with sodium citrate can help make your body fluids, especially the urine, less acidic; however, certain side effects may occur.
Muscle Spasms
Tetany is the word used to describe sudden-onset, intensely powerful contractions of your muscle groups. The medical reference UpToDate lists these muscle spasms as one possible side effect of sodium citrate. Although sodium citrate is generally considered a safe medication, especially if you have healthy, functioning kidneys, the experience of uncontrolled muscle spasms and contractions may be a very painful one. It could result in muscle tears or bone fractures, notes MedlinePlus. Because of this possibility, if you are taking sodium citrate, contact your physician if you notice sudden muscle pain or uncontrolled contractions of the hand or foot muscles.
- Tetany is the word used to describe sudden-onset, intensely powerful contractions of your muscle groups.
- Although sodium citrate is generally considered a safe medication, especially if you have healthy, functioning kidneys, the experience of uncontrolled muscle spasms and contractions may be a very painful one.
Elevated Sodium
Electrolyte Imbalance in Kidney Failure
Learn More
Hypernatremia, or elevated sodium in the blood, is another possible side effect associated with sodium citrate. While those with normal kidneys should be able to tolerate sodium citrate with no change to their normal levels of sodium, some individuals with damage to their kidneys may not tolerate this medication. This is because, as the name implies, sodium citrate contains the mineral sodium in it. If your kidneys are not working normally, the sodium not be excreted; instead, sodium will build up in the bloodstream and lead to hypernatremia. Symptoms of mild hypernatremia include drowsiness and weakness. As the levels of sodium in the blood increase, symptoms become more severe and may include seizures or even death. On the website UpToDate, Dr. Burton Rose reports that for more severe symptoms to occur, sodium levels generally must increase very quickly to a concentration greater than 158 milliequivalents per liter. MedlinePlus lists the normal range of sodium as 135 to 145 mEq/L but notes that each laboratory will define its own normal range.
- Hypernatremia, or elevated sodium in the blood, is another possible side effect associated with sodium citrate.
- If your kidneys are not working normally, the sodium not be excreted; instead, sodium will build up in the bloodstream and lead to hypernatremia.
Metabolic Alkalosis
Metabolic alkalosis is in some ways the complement of metabolic acidosis: It is a condition in which there is a buildup of a base, called bicarbonate, in the bloodstream. Patients taking sodium citrate may develop metabolic alkalosis because, as explained by UpToDate, the drug itself is metabolized, or broken down, to bicarbonate. A patient who is unable to excrete this excess bicarbonate — perhaps due to damaged or failing kidneys — will develop alkalosis, with symptoms such as confusion, dizziness, or strange sensations such as numbness or tingling in the hands and feet.
Related Articles
References
- UpToDate: Sodium Citrate: Drug Information: Lexi-Comp Inc.
- MedlinePlus: Metabolic Acidosis
- MedlinePlus: Tetanus
- MedlinePlus: Sodium: Blood
- UpToDate; Manifestations of Hyponatremia and Hypernatremia; B. Rose; May 2010
- MedlinePlus: Alkalosis
- Babaliche P, Madnani S, Kamat S. Clinical Profile of Patients Admitted with Hyponatremia in the Medical Intensive Care Unit. Indian J Crit Care Med. 2017;21(12):819-824. doi:10.4103/ijccm.IJCCM_257_17
- Filippatos TD, Makri A, Elisaf MS, Liamis G. Hyponatremia in the elderly: challenges and solutions. Clin Interv Aging. 2017;12:1957-1965. doi:10.2147/CIA.S138535
- National Institute of Diabetes and Digestive and Kidney Diseases. Hypothyroidism (Underactive Thyroid). Published August 2016.
- Godek SF, Peduzzi C, Burkholder R, Condon S, Dorshimer G, Bartolozzi AR. Sweat rates, sweat sodium concentrations, and sodium losses in 3 groups of professional football players. J Athl Train. 2010;45(4):364-71. doi:10.4085/1062-6050-45.4.364
- Gankam Kengne F, Decaux G. Hyponatremia and the Brain. Kidney Int Rep. 2018;3(1):24-35. doi:10.1016/j.ekir.2017.08.015
- Yasir M, Mechanic OJ. Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH). In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Updated April 2, 2019.
- Liamis G, Milionis H, Elisaf M. A review of drug-induced hyponatremia. Am J Kidney Dis. 2008;52(1):144-53. doi:10.1053/j.ajkd.2008.03.004
- Yee AH, Burns JD, Wijdicks EF. Cerebral salt wasting: pathophysiology, diagnosis, and treatment. Neurosurg Clin N Am. 2010;21(2):339-52. doi:10.1016/j.nec.2009.10.011
- U.S. Food & Drug Administration. Use the Nutrition Facts Label to Reduce Your Intake of Sodium in Your Diet. Updated June 8, 2018.
- Rondon H, Badireddy M. Hyponatremia. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Updated December 13, 2018.
- Kapoor K, Fashanu O, Post WS, Lutsey PL, Michos ED, deFilippi CR, McEvoy JW. Relation of Dietary Sodium Intake With Subclinical Markers of Cardiovascular Disease (from MESA). Am J Cardiol. 2019 May 29. pii: S0002-9149(19)30581-8. doi:10.1016/j.amjcard.2019.05.014
Writer Bio
Shira Goldenholz has been writing since 2001. She has edited a neurosciences coursebook and co-authored an article published in the "Journal of Child Neurology." She has contributed to a report on children's mental health and has written for an autism website. She holds a medical degree from the University of Wisconsin-Madison and a Master in Public Health from Boston University.