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**Citric acid + sodium citrate** is an oral urinary and systemic alkalinizing solution referred to in the University of Cologne nephrocalcinosis study as alkaline citrate or Shohl's solution. The citrate component increases urinary citrate availability and can complex ionized calcium, reducing the chemical propensity for calcium-containing crystal formation; sodium citrate is metabolized to bicarbonate and raises urinary pH. The University of Cologne evaluated prophylactic oral alkaline citrate in a completed Phase 3 trial in preterm infants younger than 32 weeks' gestation who were at risk of nephrocalcinosis because of hypocitraturia.
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