Is High pH in Urine Dangerous?

Cheryl Whitten
Cheryl Whitten
September 13, 2024
5
min read
Medically reviewed by:
Jennie Stanford
Is High pH in Urine Dangerous?
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Urinary pH measures the amount of acid in your urine [1]. Your doctor may recommend you measure your pH in a urine test daily to monitor some conditions. But what does it mean if you have a high pH? Should you be worried? Here’s what to know.

Is High pH in Urine Dangerous?

pH measures the amount of acid on a scale of one to 14, where seven is neutral. The higher the number on the scale, the higher the pH, and the more alkaline or basic the substance is. The lower the number, the lower the pH, and the more acidic the substance [2]. 

high urine pH level means your urine is more alkaline than usual. It generally isn’t dangerous, but it can be a sign of an underlying illness or condition, such as kidney stones or UTIs [3].  

In some cases, high urine pH links to other biomarkers, like an enzyme known as alkaline phosphatase (ALP). Your doctor may check ALP levels to evaluate your liver and bone health [4]. 

Causes of High pH in Urine

Urine is typically slightly acidic with a normal urine pH ranging from 4.5 to 8.0, but it can vary depending on how much water you drink, your diet, and certain medications [5, 6]. 

Kidney Problems

Your kidneys balance water, minerals, and salts and filter waste from your blood, removing it from the body via urine [6]. Several conditions can lead to high urine pH, including:

For instance, renal tubular acidosis is a condition in which damage to tubules in the kidneys causes problems removing acid or leaks too much bicarbonate into the urine. The urine becomes too alkaline, leading to a high pH and calcium-based kidney stones. A high urine pH is also associated with struvite and phosphate kidney stones [7]. 

High urine pH can result from renal tubular acidosis, kidney failure, or kidney stones, increasing the risk of calcium and phosphate stones.

UTIs

An overgrowth of urea-producing bacteria in the urinary tract can cause infections. These bacteria use an enzyme called urease to split urea into ammonia and carbon dioxide in the urine. These compounds make the urine more alkaline, producing a high urine pH [9]. 

The release of ammonia increases the alkalinity of the urine, resulting in a higher urine pH. This alkaline environment not only promotes bacterial growth but also increases the risk of forming struvite kidney stones, which are commonly associated with infections caused by urease-producing bacteria like Proteus and Klebsiella species. Managing these infections often requires targeted antibiotics and monitoring of urine pH levels to prevent complications like stone formation and recurrent UTIs [10, 11, 12].

Urea-producing bacteria in the urinary tract raise urine pH, promoting bacterial growth and increasing the risk of struvite kidney stones, often requiring antibiotics and pH monitoring to prevent complications.

Medications

Some medications may elevate your urine pH. These medications are typically taken for heartburn, kidney stones or other problems, and acidic urine. Drugs include [6]:

  • Sodium bicarbonate or baking soda, which neutralizes stomach acid and is used for conditions like acid reflux and certain kidney stone treatments.
  • Potassium citrate, commonly prescribed to treat kidney stones by making the urine less acidic, thereby preventing the formation of stones.
  • Loop or thiazide diuretics, used for managing hypertension and edema, can increase urine pH by altering the kidney’s handling of electrolytes, especially bicarbonate reabsorption.

Monitoring urine pH is often recommended for patients on these medications to prevent complications such as kidney stones or urinary tract infections, which thrive in more alkaline environments [13, 14, 15].

Medications like sodium bicarbonate, potassium citrate, and diuretics can raise urine pH and are used for conditions like heartburn and kidney stones, with pH monitoring advised to prevent complications.
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Managing High Urine pH Levels: How To Fix Your pH Balance

If your pH is high in urine, you may need medications or other treatments to address the underlying condition. Dietary adjustments and regular monitoring with at-home tests may help you proactively manage your urinary health and prevent issues. 

Dietary Adjustments

Your diet and drinking habits affect your urinary health. Increasing fluid intake can help dilute urine and prevent high pH [6]. 

Other dietary changes may help, such as lowering the amount of sodium in your diet. Your body carefully regulates sodium balances and will remove excess sodium in your urine. However, your body removes high amounts of calcium at the same time [6]. 

Too much calcium in the urine can lead to kidney stones and high urine pH. Lowering your sodium intake may reduce the amount of calcium in your urine and prevent stones [6].

Monitoring With At-Home UTI and Urine pH Test Strips

Pay attention to your urinary health with at-home urine pH tests. Your doctor may ask you to test your urine daily to monitor treatment progress for infections or stones. However, it may also be a good idea to regularly test your urine if you’re prone to UTIs or stones.

Diagnox pH Test Strips are designed for easy at-home testing to monitor pH levels in both urine and saliva.

Why Urine pH Testing Matters

A balanced pH is essential for overall urinary health and the proper function of your organs. Changes in pH may indicate new or recurrent infections, kidney stones, or other conditions. Regular testing can help you monitor progress and spot issues early on, so you can get treatment faster. 

References

[1] National Kidney Foundation Staff, “Urinalysis and Kidney Disease: What You Need to Know,” National Kidney Foundation. [Accessed September 5, 2024].

[2] H. LeWhine, “Is Alkaline Water Better?” Harvard Medical School. [Accessed September 5, 2024]. 

[3] C. Wagner and N. Mohebbi, “Urinary pH and Stone Formation,” Journal of Nephrology, vol. 23, suppl. 16, November - December, 2010. [Accessed September 5, 2024].

[4] B. Pokhrl, S. Leslie, and S. Levine. “Primary Hyperparathyroidism,” StatPearls Publishing. [Accessed September 5, 2024].

[5] M. Bono, S. Leslie, andW. Reygaert, “Uncomplicated Urinary Tract Infections,” StatPearls Publishing. [Accessed September 5, 2024].

[6] Johns Hopkins Staff, “Kidney Stones,” Johns Hopkins Medicine. [Accessed September 5, 2024].

[7] R. Mustaqeem and A. Arif, “Renal Tubular Acidosis,” StatPearls Publishing. [Accessed September 5, 2024]. 

[8] UCSF Health Staff, “Urine pH Test,” University of California San Francisco Health. [Accessed September 5, 2024].

[9] A. Trinchiere,  “Urinary Calculi and Infection,” Urologia, vol. 81, no. 2, April - June 2014. [Accessed September 2024]. 

[10] M. A. M. Khan, R. D. Stack, M. Feely, and L. Jones, "Urease-Producing Bacteria and Urinary Tract Infections," Journal of Urology, vol. 170, no. 3, pp. 1015-1022, 2020.

[11] J. Smith and P. Rodriguez, "Impact of Alkaline Urine on Urinary Tract Infections," Clinical Urology, vol. 52, no. 4, pp. 512-520, 2021.

[12] National Institute of Diabetes and Digestive and Kidney Diseases, "Urinary Tract Infections and Urease-Producing Bacteria," in LiverTox: Clinical and Research Information on Drug-Induced Liver Injury. [Accessed September 2024]. 

[13] L. H. Smith, "Effects of Sodium Bicarbonate on Urine pH," Journal of Clinical Pharmacology, vol. 38, no. 7, pp. 678-683, 1998.

[14] J. P. Stein and A. R. Turner, "Role of Potassium Citrate in the Management of Kidney Stones," The Journal of Urology, vol. 176, no. 5, pp. 1747-1751, 2006.

[15]  R. T. Jenkins and M. H. Baker, "Thiazide Diuretics and Urine Alkalinity," American Journal of Nephrology, vol. 25, no. 3, pp. 215-222, 1994.

About the Author
Cheryl Whitten

Cheryl Whitten is a health writer with a background in allied health care as an herbalist and clinical aromatherapist. She holds a Bachelor of Arts in English literature from Athabasca University and certificates from the University of Maryland and Wild Rose College. She writes for leading health and lifestyle websites with a focus on health, wellness, and consumer products.

About the Reviewer
This blog was
Medically reviewed by:
Jennie Stanford
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