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Hyperuricosuric calcium urolithiasis.

Orson W Moe1,2,3, Li Hao Richie Xu4

  • 1Charles and Jane Pak Center for Mineral Metabolism and Clinical Research, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX, 75390-8885, USA. orson.moe@utsouthwestern.edu.

Journal of Nephrology
|January 26, 2018
PubMed
Summary
This summary is machine-generated.

Hyperuricosuric calcium urolithiasis involves mixed calcium oxalate stones. Lowering uric acid may reduce stone events in specific patients, but more research is needed for personalized treatment.

Keywords:
Calcium oxalateHyperuricosuriaUrolithiasis

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Area of Science:

  • Nephrology
  • Urology
  • Biochemistry

Background:

  • Hyperuricosuric calcium urolithiasis is characterized by mixed calcium oxalate stones and hyperuricosuria.
  • Urate can promote calcium oxalate precipitation through various physicochemical mechanisms.
  • Existing treatments for calcium oxalate stones may fail in patients with hyperuricosuria.

Purpose of the Study:

  • To explore the role of urate in calcium oxalate stone formation.
  • To evaluate the efficacy of uric acid lowering in managing hyperuricosuric calcium urolithiasis.
  • To identify the need for refined pathogenic models and targeted clinical trials.

Main Methods:

  • Review of physicochemical models of urate's role in stone formation.
  • Analysis of retrospective data and prospective trials on uric acid lowering.
  • Examination of the association between uric acid excretion and kidney stone risk in diverse populations.

Main Results:

  • Urate demonstrably increases calcium oxalate precipitation propensity.
  • Uric acid lowering has shown potential in reducing stone events in hyperuricosuric calcium stone formers.
  • A direct association between uric acid excretion rate and kidney stone risk is not consistently found in the general population due to heterogeneity.

Conclusions:

  • Urate plays a significant role in calcium oxalate urolithiasis pathogenesis.
  • Cautious attempts at uric acid lowering may be beneficial for specific patient subgroups with refractory calcium oxalate stones.
  • Further research with refined models and phenotypically defined trials is essential for optimizing treatment strategies.