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To the Editor.—
In the article entitled "Renal Geology" (231:865) it was stated that alkalinization of the urine with sodium bicarbonate may sometimes be difficult and that the use of acetazolamide may be helpful in producing this effect. I was surprised by this recommendation since it is known that acetazolamide may itself produce renal calculi.What is the incidence of acetazolamide-produced renal calculi and what is their composition? As an ophthalmologist who uses acetazolamide, I would also appreciate knowing what measures the ophthalmologist should take to reduce the potential for renal calculus formation in a patient who is using this medication.
Davis RH. Alkalinization of Urine. JAMA. 1975;233(2):138. doi:10.1001/jama.1975.03260020024010