True or false: Potassium citrate to prevent uric acid stone

In 2010, when I lived in the US, I was diagnosed with high uric acid and at the same time, I had uric acid stone. Met with Urologist who look closely at my uric acid level based on 24 hour urine collection.

Back then, only by dieting and watch what I eat, I was able to lower the uric acid to normal level.

Since 2012 I live in Calgary, Canada and in 2015, dieting alone was not enough anymore. My uric acid was above normal and I had uric acid stone again. My family doctor prescribed Allopurinol 300mg/day to control my uric acid level and I do not question this medicine.

I also met Nephrologist who prescribe Hydrochlorothiazide 50mg/day to prevent uric acid stone and this what I'm questioning.

Fast forward to 2020, I was browsing my condition and came across info about Potassium Citrate to prevent uric acid stone if urine pH is below 5.5. I did urinalysis in Aug and it was 5.0. I came across the information from a Professor at Univ of Chicago.

My family doctor moved to a different location, so, I met with another doctor to discuss Potassium Citrate. Doctor looks annoyed that I found this on the internet but suggested me to met with Internist.

Met with Internist who is against Potassium Citrate due to the following:

• We can’t objectively measuring urine pH because it keeps changing in seconds due to the many various elements affecting the pH. That said, even if I’m taking potassium citrate, we won’t know the true urine pH level
• Potassium citrate is expensive
• Potassium citrate can affect kidney
• The ultimate key to prevent uric acid stone is by maintaining the uric acid into normal level which is what allopurinol is supposed to be doing and therefore, knowing I don’t have any stone in the past 5 years while taking hydrochlorothiazide and allopurinol (and unless the situation is changing), potassium citrate really has no use to prevent uric acid stone in my particular case
• Hydrochlorothiazide is for preventing uric acid stone, so, I'm already taking the right medicine

I communicate with Prof@Univ of Chicago who disagree with what the Internist is saying. In order to find the truth, I met with my original family doctor who is also against Potassium Citrate due to the following reasoning:

• Pottasium Citrate is not a common treatment in Canada
• I don't have uric acid stone since 2015, so, why change the regimen knowing that the current regimen is working
• Pottasium Citrate has serious side effect. My doctor said, she will have to do the following every 4 months: check my blood for renal function, put me on ECG, etc.

I communicate with Prof@Univ of Chicago who, once again, disagree with what this doctor was saying.

That said, with the exception of Prof@Univ of Chicago, not a single doctor, in the US and in Canada, believe that Potassium Citrate is the right regimen to prevent uric acid stone and I'm here because I want to find the truth and confirm whether Hydrochlorothiazide or Potassium Citrate is the right regimen for me.

If Potassium Citrate is the right regimen, then, I don't know how can I use Potassium Citrate because every doctor I met don't believe that Potassium Citrate is the right regimen.

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