Would you avoid potassium citrate initiation in a pregnant patient with hypocitraturia and recurrent calcium oxalate nephrolithiasis?

Difficult question to answer. There is no clear contraindication; however, if her urine pH is OK, I would likely avoid it. I would make sure she is adequately hydrated and would recommend having fresh squeezed Lemons to help. However, if it appears necessary to use it, I would.

I agree with Dr. @Dr. First Last, there is no clear contraindication. However, it would not be my first step. Preferable would be to optimize dietary and fluid therapy first.

Stephen B. Erickson, MD