Do you avoid potassium citrate due to concerns with increasing the urine pH in patients with recurrent struvite nephrolithiasis who also have hypocitraturia?

Thanks for asking! My answer is: In general, "No", but it depends...

Struvite stones can only form at un-physiologically high urine pHs. This situation occurs when urease-producing bacteria cause urinary infection. Urease splits normally occurring urinary urea to ammonium, raising the urine pH >7.0 ...