Epidemiology, pathophysiology, and management of uric acid urolithiasis: A narrative review

Abou-Elela, Ashraf

doi:10.1016/j.jare.2017.04.005

Cited by 94 publications

(83 citation statements)

References 108 publications

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“…Urinary concentration of uric acid depends on urine pH, urine volume and excretion of uric acid. Urinary pH is the most important factor in uric acid solubility . Oral alkaline citrate or sodium bicarbonate is used for chemolysis through alkalinization of the urine .…”

Section: Clinical Questions and Answersmentioning

confidence: 99%

“…Urinary pH is the most important factor in uric acid solubility. 143 Oral alkaline citrate or sodium bicarbonate is used for chemolysis through alkalinization of the urine. 144 Although the efficiency of chemolysis is directly proportional to higher pH, the pH should be adjusted in the range of 7.0-7.2 to prevent formation of calcium phosphate calculus.…”

Section: Commentarymentioning

confidence: 99%

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The Urological Association of Asia clinical guideline for urinary stone disease

et al. 2019

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The Urological Association of Asia, consisting of 25 member associations and one affiliated member since its foundation in 1990, has planned to develop Asian guidelines for all urological fields. The field of stone diseases is the third of its guideline projects. Because of the different climates, and social, economic and ethnic environments, the clinical practice for urinary stone diseases widely varies among the Asian countries. The committee members of the Urological Association of Asia on the clinical guidelines for urinary stone disease carried out a surveillance study to better understand the diversity of the treatment strategy among different regions and subsequent systematic literature review through PubMed and MEDLINE database between 1966 and 2017. Levels of evidence and grades of recommendation for each management were decided according to the relevant strategy. Each clinical question and answer were thoroughly reviewed and discussed by all committee members and their colleagues, with suggestions from expert representatives of the American Urological Association and European Association of Urology. However, we focused on the pragmatic care of patients and our own evidence throughout Asia, which included recent surgical trends, such as miniaturized percutaneous nephrolithotomy and endoscopic combined intrarenal surgery. This guideline covers all fields of stone diseases, from etiology to recurrence prevention. Here, we present a short summary of the first version of the guideline – consisting 43 clinical questions – and overview its key practical issues.

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Section: Clinical Questions and Answersmentioning

confidence: 99%

Section: Commentarymentioning

confidence: 99%

The Urological Association of Asia clinical guideline for urinary stone disease

et al. 2019

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“…Though there are global diversities in uric acid stone prevalence, obesity, diabetes and hypertension are commonly associated with uric acid stones in Western societies 2. Patients with uric acid stones might have similar symptoms as patients with calcium stones, uric acid stones, but have different stone formation characteristics, radiological diagnosis and treatment strategies 3. First, uric acid stones have special radiologic features because they are radiolucent4 5; second, uric acid stones can be dissolved by appropriate oral medicine6 7; third, the incidence of uric acid stones is higher in patients with systemic metabolic-related disorders such as obesity and diabetes 8 9.…”

Section: Introductionmentioning

confidence: 99%

Uric acid stones, clinical manifestations and therapeutic considerations

et al. 2018

Postgraduate Medical Journal

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Uric acid stones account for 10%-15% of all urinary stones. Changes in dietary habits, environment or both can result in the increase of uric acid stones. The formation of uric acid stones is related to hyperuricosuria, low urinary volume and persistently low urinary pH. Diabetes and obesity also significantly increase the risk of stone formation. Dual-energy CT provides a convenient and reliable method for diagnosis. Stone composition analysis and 24-hour urine metabolic evaluations should be considered for further evaluation. Most small uric acid stones (diameter <2 cm) can be treated by pharmacotherapy or extracorporeal shock wave lithotripsy. However, ureteroscopy and other minimally invasive procedures should be reserved for larger stones (diameter ≥2 cm), or patients with concomitant urinary tract obstruction and/or infections. Additionally, adjustment of potential pathophysiologic defects by pharmacotherapy and dietary modification is strongly recommended for the prevention of uric stone recurrence.

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“…There is indeed abundant evidence on the detrimental effect of high urinary excretion of uric acid on kidney function [23] and on high serum uric acid as an indicator of impaired kidney function [24]. The urate salt, especially in the form of calcium salt, may become calculi or crystalline in the kidney and damage the function of the kidneys [23].…”

mentioning

confidence: 99%

“…The urate salt, especially in the form of calcium salt, may become calculi or crystalline in the kidney and damage the function of the kidneys [23]. Impaired renal function may influence sodium metabolism and increase the risk of hypertension.…”

mentioning

confidence: 99%

Dietary Sodium Intake and Serum Uric Acid: A Mini-Review

Lei

Wang

2018

Pulse

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The aim of the present review is to summarize recent studies on the relationship between dietary sodium intake and serum uric acid concentration. In short-term dietary sodium intervention studies, including a recent further analysis of a previously published trial, high dietary sodium intake (200 mmol/day), compared with a low sodium diet (20–60 mmol/day), resulted in a significant reduction in serum uric acid, being approximately 20–60 μmol/L. This finding, though consistent across short-term studies, is in contradiction to the long-term observational evidence on the relationship between dietary sodium intake and serum uric acid. Indeed, in a population-based prospective study, high dietary sodium intake was associated with a higher serum uric acid concentration. If serum uric acid would be followed up, several currently ongoing long-term randomized dietary sodium intervention studies may shed some light on how dietary sodium intake interacts with serum uric acid in the development of hypertension.

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Epidemiology, pathophysiology, and management of uric acid urolithiasis: A narrative review

Abstract: Graphical abstractQuoted from Urolithiasis – EAU Guidelines 2016 with adaptation.

Cited by 94 publications

References 108 publications

The Urological Association of Asia clinical guideline for urinary stone disease

The Urological Association of Asia clinical guideline for urinary stone disease

Uric acid stones, clinical manifestations and therapeutic considerations

Dietary Sodium Intake and Serum Uric Acid: A Mini-Review

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