Daily administration of a citrate mixture (3.5 g twice daily) for 12 weeks in Chinese men with renal underexcretion-type gout and urinary pH below 6.2 was associated with a 24.4 percentage point reduction in gout flare incidence compared to no alkalization.

When urine becomes less acidic, it prevents uric acid from forming sharp crystals in the joints. These crystals normally trigger a chain reaction in immune cells that releases powerful inflammatory signals, drawing in white blood cells that cause pain and swelling. Alkaline urine stops this chain reaction at its start, so fewer inflammatory signals are made and fewer white blood cells rush to the joints, preventing flare-ups.