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.
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.
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.
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.