Dissolution of uric acid calculi with systemic alkalization.

Area of Science:

• Nephrology
• Urology
• Biochemistry

Background:

• Uric acid calculi are a significant cause of kidney stones.
• Current treatments for uric acid calculi include oral alkalinizing agents, which can lead to intermittent urinary pH changes.
• Achieving sustained urinary alkalization is crucial for effective uric acid stone dissolution.

Purpose of the Study:

• To evaluate the efficacy of continuous intravenous infusion of lactate solution for dissolving uric acid calculi.
• To compare the effectiveness of sustained urinary alkalization via intravenous infusion versus intermittent alkalization from oral agents.

Main Methods:

• Fourteen patients with uric acid calculi (renal pelvis, calices, or ureter) were treated.
• A constant intravenous infusion of a one-sixth molar lactate solution was administered.
• Urinary pH levels and stone dissolution were monitored.

Main Results:

• Dissolution of uric acid calculi was successful in 12 out of 14 patients (85.7%).
• The treatment was effective for stones located in both the renal pelvis/calices and the ureter.
• No significant complications were reported during the infusion period.

Conclusions:

• Constant intravenous infusion of lactate solution is a highly effective method for dissolving uric acid calculi.
• Sustained urinary alkalization achieved through intravenous infusion is key to successful stone dissolution.
• This approach offers a promising alternative to oral therapies for managing uric acid nephrolithiasis.