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Uric Acid NephrolithiasisAka: Urate Stones, Hyperuricosuria, Uric Acid Calculi

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  1. See Also
    1. Nephrolithiasis
    2. Gouty Arthritis
  2. Evaluation
    1. See Nephrolithiasis
  3. Types
    1. Pure Uric Acid calculi
    2. Mixed calcium and Uric Acid calculi
  4. Causes
    1. Primary cause
      1. Acidic urine (pH <5.5)
    2. Other causes
      1. Gouty Arthritis (confers 2 fold risk of calculi)
      2. Excessive dietary purine intake (meats)
      3. Insulin Resistance
      4. End Ileostomy
  5. Labs
    1. AM spot urine for Urine pH and Crystaluria
  6. Radiology
    1. Non-contrast abdominal CT
    2. XRay abdomen
      1. Pure Uric Acid calculi are radiolucent
      2. May be visualized if mixed calcium and Uric Acid
  7. Management: Prevention of Uric Acid stone recurrence
    1. General
      1. Restrict dietary intake of sodium and protein
      2. Maintain Urine output: over 2.5 liters per day
    2. Alkalinize urine (especially if Urine pH is low)
      1. Maintain Urine pH >5.5 (6.5 - 7.0 preferred)
      2. Potassium Citrate (or sodium citrate)
        1. Dose: 30-60 mEq/day
    3. Hyperuricosuria (>800 mg/day)
      1. Potassium citrate as above
      2. Allopurinol 100-300 mg/day
      3. Purine (protein) restriction
      4. Reduce Urine Uric Acid excretion
  8. References
    1. Shekarriz (2002) J Urol 168:1307

Hyperuricosuria (C0948643)

ConceptsFinding (T033)
EnglishHyperuricosuria
SourcesOMIM
Derived from the NIH UMLS (Unified Medical Language System)



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