Dietary aspects of uric acid stone disease

Kidney stones composed of uric acid present a treatment challenge, particularly in terms of successful prevention of recurrence over the long term. Between 5-12% of all stone patients form calculi composed partially or completely of uric acid. These stones have traditionally been treated with a combination of pharmacological and surgical techniques. The role of diet and fluids in the pathogenesis and management is gradually being recognized and there is potential for dietary intervention to become a major treatment modality for this type of stone. This paper discusses the stone formation process, the metabolism or uric acid and its physical and chemical properties. Specific risk factors for uric acid calculi formation are covered. Dietary protein is reviewed in detail. A comprehensive strategy for the dietary management of uric acid renal calculi disease is suggested.