TABLE 2.
Included randomized controlled trials for studying the effect of alkaline supplements on bone health1
| Cochrane risk-of-bias assessment | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| First author, year (reference) | Design | Participants | Intervention | Diet period (washout)2 | Exposure quantified | Outcomes | Sequence generation | Allocation concealment | Blinding | Selective outcome reporting | Other sources of bias |
| Macdonald, 2008 (34) | Parallel | 188 Postmenopausal women (aged 55–65 y) | K+ citrate (55.5 mEq/d) or placebo | 2 y | NEAP, urinary pH | BMD, urinary calcium, BTM | Low | Unclear | Low | Low | Low |
| Jehle, 2006 (42) | Parallel | 161 Postmenopausal women (age <70 y) | K+ citrate (30 mEq/d) or K+ chloride (30 mEq/d) | 1 y | NAE | Calcium excretion, BMD, BTM | Low | Low | Low | Low | Low |
| Granchi, 2018 (36) | Parallel | 40 Postmenopausal women (age >55 y) | K+ citrate (30 mEq/d) or placebo | 6 mo | PRAL, urinary pH | Calcium excretion, BTM | Low | Low | Low | Low | Low |
| Gregory, 2015 (38) | Parallel | 83 Postmenopausal women (age 65.6 ± 6.5 y) | K+ citrate (40 mEq/d) or placebo | 1 y | Urinary pH | Calcium excretion, BMD, BTM | Low | Unclear | Low | Unclear | Low |
| Sakhaee, 2005 (45) | Crossover | 18 Postmenopausal women (age 48–76 y) | K+ citrate (40 mmol/d) or placebo | 2 wk (2 wk) | Urinary pH | Calcium excretion, BTM | Low | Low | Low | Low | Low |
| Jehle, 2013 (35) | Parallel | 201 Healthy men and women (>65 y) | K+ citrate (60 mEq/d) or placebo | 1 y | NAE | Calcium excretion, BMD, BTM | Low | Unclear | Low | Low | Low |
| Dawson-Hughes, 2015 (37) | Parallel | 233 Healthy men and women (age >50 y) | K+ bicarbonate (1 mmol/kg/d) or (1.5 mmol/kg/d) | 3 mo | NAE, urinary pH | Calcium excretion, BTM | Low | Unclear | Low | Low | Low |
| Dawson-Hughes, 2009 (40) | Parallel | 171 Healthy men and women (>50 y) | KHCO3/NaHCO3 or KCl/placebo (67.5 mmol/d) | 3 mo | NAE | Calcium excretion, BTM | Low | Unclear | Low | Low | Low |
| Ceglia, 2009 (41) | Parallel | 19 Healthy subjects (age 54–82 y) | K+ bicarbonate (90 mmol/d) or placebo | 25 d | NAE | Calcium balance, BTM | Low | Unclear | Low | Low | Low |
| Frassetto, 2005 (43) | Parallel | 170 Postmenopausal women (age 61 ± 7 y) | K+ bicarbonate (90 mmol/d) or placebo | 36 mo | Urinary pH | Calcium excretion | Low | Unclear | High | Low | Low |
| He, 2010 (44) | Crossover | 42 Individuals with untreated mildly raised blood pressure | K+ bicarbonate or placebo (64 mmol/d) | 4 wk | Urinary pH | Calcium excretion, BTM | Low | Unclear | Low | Low | Low |
| Moseley, 2013 (39) | Parallel | 52 Healthy men and women (age 65.2 ± 6.2 y) | K+ citrate (90 mmol/d) or placebo | 6 mo | NAE | Calcium balance, BTM | Low | Unclear | Low | Low | Low |
| Sakhaee, 1983 (46) | Crossover | 5 Patients with documented uric acid lithiasis (age 42–69 y) | K+ chloride (60 mEq/d) or placebo | 4 wk (3 wk) | Urinary pH | Calcium excretion | Low | Unclear | Low | Low | Low |
1BMD, bone mineral density; BTM, bone turnover marker; crossover, random crossover study; NAE, net acid excretion; NEAP, net endogenous acid production; parallel, random control trial; PRAL, potential renal acid load.
2
“period” indicates means diet intervention time (washout period).