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Uric acid stones
1Nephrology Section, University of Chicago, IL 60637, USA.
Seminars in Nephrology
|September 1, 1996
Summary
Uric acid stones form in acidic urine due to poor solubility. Treatment involves urine alkalinization, increased fluid intake, and managing uric acid levels.
Area of Science:
- Nephrology
- Biochemistry
- Urology
Background:
- Uric acid is the final product of purine metabolism in humans.
- In acidic urine (pH 5.35), uric acid exists predominantly in its poorly soluble undissociated form.
- This low solubility predisposes to crystalluria and the formation of uric acid stones.
Purpose of the Study:
- To review the risk factors, formation, and treatment of uric acid stones.
- To highlight the role of urine pH in uric acid stone pathogenesis.
Main Methods:
- Literature review of uric acid stone formation.
- Analysis of risk factors including urine acidity, hyperuricosuria, and low urine volume.
Main Results:
- Uric acid stones constitute 5-10% of all kidney stones in the US.
- Risk factors for uric acid stones include acidic urine, high uric acid excretion (hyperuricosuria), and dehydration.
- Stones can be idiopathic or associated with conditions like gout.
Conclusions:
- Uric acid stone formation is linked to urine chemistry, particularly acidity.
- Management strategies focus on increasing urine pH through alkalinization and promoting hydration.
- Reducing abnormal uric acid excretion is also a key treatment component.