Urinary alkalinization

Urinary alkalinization involves increasing urine pH through the administration of agents such as sodium bicarbonate or sodium citrate. It is a therapeutic strategy used to enhance the excretion of weakly acidic drugs (like salicylates, methotrexate, or chlorpropamide), to provide symptomatic relief from dysuria during urinary tract infections, and to prevent or manage drug-induced crystalluria. Although commonly used, it is not a molecular target but rather a form of supportive care or adjunct intervention. Safety concerns include potential for drug precipitation, metabolic alkalosis, and electrolyte imbalances. Clinical guidelines frequently recommend monitoring urine pH during urinary alkalinization therapy.

Other names

Urine alkalinizationUrinary pH manipulationAlkalinisation of urineUrinary alkalisers

Administration of alkaline salts increases urinary pH, favoring ionization and renal clearance of weak acids through reduced tubular reabsorption. Alkaline pH decreases symptom severity by neutralizing acidic urine, reducing nociceptor activation in the bladder mucosa. Alteration of pH modifies solubility of certain drugs or metabolites, decreasing crystalluria risk.