Palatability Preferences of Non-Capsular Potassium Citrate Alternatives in Healthy Non-Stone-Forming Adults

Purpose: Poor adherence to potassium citrate (KCit) therapy due to palatability issues and gastrointestinal side effects presents a significant barrier to effective kidney stone prevention. While liquid and powder alternatives have emerged as potential solutions, comprehensive comparative palatability data remain limited, hampering evidence-based recommendations for clinical practice. This study aimed to evaluate and compare the palatability of four commercially available liquid KCit formulations (Litholyte, Moonstone StoneStopper, KSPTabs, and Bulk Supplements) in healthy non-stone-forming adults. Material and Methods: We conducted a blinded swish-and-spit taste-testing study enrolling 63 healthy participants who sampled each liquid KCit formulation in a randomized order. Participants rated each formulation using a validated five-point Likert scale survey assessing overall palatability, mouthfeel, taste intensity, and aftertaste. Swish-and-spit protocol was followed to minimize systemic absorption while allowing thorough taste evaluation. Results: Moonstone StoneStopper (cranberry-raspberry flavored) demonstrated superior overall palatability (mean score: 4.3 ± 0.6), followed by KSPTabs (3.2 ± 0.8), Litholyte (2.8 ± 1.1), and Bulk Supplements (1.7 ± 0.7). Mouthfeel and aftertaste scores correlated strongly with overall preference (r = 0.87 and r = 0.82, respectively). Conclusions: Flavor-masked formulations consistently outperformed unflavored options across all taste parameters. These findings suggest that flavored liquid alternatives to KCit therapy are preferred in non-stone formers. Further studies in stone-forming populations are warranted to confirm these results, assess gastrointestinal side effects and evaluate long-term adherence.