What is your approach for managing patients with recurrent nephrolithiasis and hypercalciuria who experience significant urinary frequency symptoms after starting a thiazide diuretic?

To some degree, an increase in urine volume and frequency is expected and even desirable after starting a diuretic. Diluting urinary mineral concentration is a major goal in inactivating metabolic stone disease.

If frequent voiding is problematic, urological consultation might be in order, looking f...

Apart from a brief natriuresis with accompanying increase of urine volume, thiazide diuretics do not raise total daily urine volume. Exceptions include hypokalemia with acquired concentrating ability. Frequency sans polyuria means lower urinary origin, and thiazides will not have such effects. Ultim...