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Uric acid nephrolithiasis.

Scott E Liebman1, Jeremy G Taylor, David A Bushinsky

  • 1University of Rochester School of Medicine and Dentistry, Nephrology Division, Strong Memorial Hospital, Rochester, NY 14642, USA. scott_liebman@urmc.rochester.edu

Current Rheumatology Reports
|May 29, 2007
PubMed
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Uric acid nephrolithiasis, linked to acidic urine and conditions like gout or diabetes, requires urine alkalinization for treatment. Diagnosis can be challenging due to radiolucent stones.

Area of Science:

  • Nephrology
  • Urology
  • Metabolic Disorders

Background:

  • Uric acid nephrolithiasis is associated with low urine pH and normal urinary uric acid levels.
  • Risk factors include gout, obesity, diabetes, and metabolic syndrome, all linked to acidic urine excretion.
  • The unifying factor in these conditions is the excretion of abnormally acidic urine.

Purpose of the Study:

  • To explore the relationship between metabolic disorders and the development of uric acid stones.
  • To highlight diagnostic challenges and recommended imaging techniques for uric acid stones.
  • To outline current treatment strategies for uric acid nephrolithiasis.

Main Methods:

  • Review of literature focusing on the pathophysiology of uric acid stone formation.

Related Experiment Videos

  • Discussion of diagnostic modalities including plain radiography, ultrasound, and noncontrast helical CT.
  • Analysis of treatment approaches including urine alkalinization and lifestyle modifications.

    • Main Results:

    • Pure uric acid stones are radiolucent, making diagnosis difficult with standard radiographs.
    • Abnormally acidic urine is a common finding in patients with uric acid stones and associated metabolic disorders.
    • Urine alkalinization with citrate or bicarbonate salts is a primary treatment strategy.

    Conclusions:

    • Uric acid stones are strongly linked to conditions causing acidic urine excretion.
    • Effective diagnosis requires advanced imaging like CT scans.
    • Treatment focuses on urine alkalinization, hydration, dietary changes, and potentially lowering serum uric acid levels.