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Uric acid saturation in calcium nephrolithiasis

F L Coe, A L Strauss, V Tembe

    Kidney International
    |May 1, 1980
    PubMed
    Summary
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    Hyperuricosuria, or high uric acid in urine, increases the risk of calcium oxalate kidney stones. This study found that hyperuricosuria leads to urine supersaturation, promoting stone formation.

    Area of Science:

    • Nephrology
    • Urology
    • Biochemistry

    Background:

    • Hyperuricosuria is linked to calcium oxalate nephrolithiasis.
    • Proposed mechanisms involve crystal formation or inhibition of crystallization inhibitors.
    • Urine supersaturation in hyperuricosuria under normal lifestyle conditions requires investigation.

    Purpose of the Study:

    • To assess urine saturation with respect to sodium hydrogen urate and undissociated uric acid in patients with calcium nephrolithiasis.
    • To determine the association between hyperuricosuria and urine supersaturation.
    • To evaluate the impact of treatments reducing uric acid excretion on urine saturation.

    Main Methods:

    • Urine samples from 67 patients with calcium nephrolithiasis were analyzed.
    • Patients were categorized based on idiopathic hypercalciuria and hyperuricosuria.

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  • Measurements included saturation with sodium hydrogen urate and concentration of undissociated uric acid.

    • Main Results:

    • Patients with hyperuricosuria more frequently exhibited urine supersaturation.
    • This supersaturation was observed for monosodium urate or undissociated uric acid.
    • Higher risk of forming solid monosodium urate or uric acid phases was noted in hyperuricosuric patients.

    Conclusions:

    • Hyperuricosuria is associated with increased urine supersaturation, elevating the risk of calcium oxalate nephrolithiasis.
    • Treatments reducing uric acid excretion lower urine saturation, potentially preventing calcium stone recurrence.