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Uric acid stones, clinical manifestations and therapeutic considerations
  1. Qi Ma1,2,
  2. Li Fang1,
  3. Rui Su1,
  4. Liang Ma2,
  5. Guohai Xie1,
  6. Yue Cheng1,2
  1. 1 Department of Urology, Ningbo First Hospital, The Affiliated Hospital of Ningbo University, Ningbo, China
  2. 2 Translational Research Laboratory for Urology, the Key Laboratory of Ningbo City, Ningbo First Hospital, The Affiliated Hospital of Ningbo University, Ningbo, China
  1. Correspondence to Dr Yue Cheng, Department of Urology, Ningbo First Hospital, The Affiliated Hospital of Ningbo University, Ningbo 315010, China; Yue.Cheng{at}eyou.com

Abstract

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.

  • uric acid stones
  • metabolism
  • physiopathology
  • diagnosis
  • therapy

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Footnotes

  • Contributors QM and LF performed the literature search and selection. RS and LM analysed the data. QM wrote the paper, and prepared the tables and figures. YC and GX revised the paper. RS submitted the paper. All authors agree and approve the final version of the manuscript.

  • Funding This project was supported by the National Natural Science Foundation of China (Grant No 81272828), Zhejiang Provincial Foundation for Medical and Health Sciences (Grant No 2016KYB263, 2014KYB355) to QM, and Ningbo Social Developing Fund (Grant No 2011C91028) to YC.

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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