Citrate is excreted in comparatively large amounts in human urine, and its excretion varies with age, diet, sex, and other factors from 100 to 1500 mg. per day.1-4 It is lower in infants and children as compared with adults.1-3,5-7 Citrate excretion is decreased by acidosis7-12 (dietary, uremic, and diabetic) and by testosterone administration.13 It is increased in alkalosis7-12 and by the administration of estrogens,14,15 parathyroid extract,2,16,17 and vitamin D.18-22
Previous experimental and clinical studies have suggested that urinary citrate aids in the chelation of calcium into a soluble complex. Low citrate levels in the presence of normal calcium-phosphorous ratios may play a role in the formation of renal calculi.2,23,24 In addition, citrate therapy has been reported to have induced an apparent improvement in a case of nephrocalcinosis.25
In rats, acetazolamide administration has been observed to result in the deposition of calcium
SHAH A, CONSTANT MA, BECKER B. Urinary Excretion of Citrate in Humans Following Administration of Acetazolamide (Diamox). AMA Arch Ophthalmol. 1958;59(4):536–540. doi:10.1001/archopht.1958.00940050092011
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