What is your approach for patients with recurrent nephrolithiasis who require daily use of acetazolamide for management of an unrelated chronic condition?  

Acetazolamide, or other carbonic anhydrase inhibitors, typically increase urine pH into the low 7s. Normally, it is approximately 6.0. A mildly alkaline urine favors the formation of brushite and hydroxyapatite kidney stones. My first step is to contact the provider who prescribed the carbonic anhy...