Conservative therapy of uric acid lithiasis: a review of literature
https://doi.org/10.21518/2079-701X-2015-4-92-95
Abstract
Urolithiasis (UL) continues to play an important role in the daily practice of urologists and general practitioners. According to various sources, uric acid nephrolithiasis accounts for about 20% of all cases of urolithiasis. Risk factors for uric acid nephrolithiasis include hyperuricemia, hyperuricosuria, decreased urine output and low urine pH. The major risk factor for UL, low urine pH, is managed by different citrate drugs. Citrate mixtures are strong base salts combined with weak acids which alkalize (neutralize) urine pH, whereas the acid component is metabolised. In patients diagnosed with hyperuricemia, uric acid production can be reduced with the help of xanthine oxidase inhibitors which act as suppressors of xanthine oxidase - an enzyme that catalyzes the oxidation of hypoxanthine to xanthine and xanthine to uric acid which is the end-product of purine metabolism in humans. The medical literature confirms the efficacy of citrate mixtures and xanthine oxidase inhibitors for the treatment of patients with uric acid nephrolithiasis.
About the Authors
V. A. Malkhasyan
Moscow State University of Medicine and Dentistry
Russian Federation
Russian Federation
I. V. Semenyakin
Moscow State University of Medicine and Dentistry
Russian Federation
Russian Federation
V. Y. Ivanov
Moscow State University of Medicine and Dentistry
Russian Federation
Russian Federation
A. S. Popova
Moscow State University of Medicine and Dentistry
Russian Federation
Russian Federation
References
1. Baker PW, CoyLe P, Bais R et aL. Influence of season, age, and sex on renaL stone formation in South Australia. Med. J. Aust., 1993, 159: 390392.
2. FederLe MP, McAninch JW, Kaiser JA et aL. Computed tomography of urinary caLcuLi. AIR Am. J. Roentgenol., 1981, 136: 255-258.
3. Resnick MI, Kursh ED, Cohen AM. Use of computerized tomography in the deLineation of uric acid caLcuLi. J. Urol., 1984, 131: 9-10.
4. Nakada SY, Hoff DG, Attai S et aL. Determination of stone composition by noncontrast spiral computed tomography in the cLinicaL setting. Urology, 2000, 55: 816-819.
5. Honda M, Yamamoto K, Momohara C et aL. OraL chemoLysis of uric acid stones. Hinyokika Kiyo., 2003, 49(6): 307-310.
6. Chugtai MN, Khan FA, KaLeem M et aL. Management of uric acid stone. J. Pak. Med. Assoc., 1992, 42(7): 153-155.
7. Rodman JS. Intermittent versus continuous aLkaLine therapy for uric acid stones and ureteraL stones of uncertain composition. Urology, 2002, 60(3): 378-382.
8. Becker A. Uric acid stones. Nephrology, 2007, 12: 21-25.
9. Weirich W, Frohneberg D, Ackermann D et aL. PracticaL experiences with antegrade LocaL chemoLysis of struvite/apatite, uric acid and cystine caLcuLi in the kidney. Urologe A., 1984, 23(2): 95-98.
10. Gutman AB, Yu TF. Uric acid nephroLithiasis. Am. J. Med., 1968, 45: 756-779.
11. Pak CY, Sakhaee K, FuLLer C. SuccessfuL management of uric acid nephroLithiasis with potassium citrate. Kidney Int., 1986, 30: 422-428.
12. Rodman JS. ProphyLaxis of uric acid stones with aLternate day doses of aLkaLine potassium saLts. J. Urol., 1991, 145: 97-99.
13. Sharma SK, Indudhara R. ChemodissoLution of urinary uric acid stones by aLkaLi therapy. Urol. Int., 1992, 48: 81-86.
14. Moran ME, Abrahams HM, Burday DE et aL. UtiLity of oraL dissoLution therapy in the management of referred patients with secondariLy treated uric acid stones. Urology, 2002, 59: 206-210.
15. Mohammad NC, Farakh AK, Mohammad K et aL. Management of uric acid stone. J. Pak. Med. Assoc., 1992: 153-155.
16. Trinchieri A, Esposito N, CasteLnuovo C. DissoLution of radioLucent renaL stones by oraL aLkaLini-zation with potassium citrate/potassium bicarbonate. Arch. Ital. Urol. Androl., 2009, 81(3): 188-191.
17. Moran ME, Abrahams HM, Burday DE et aL. UtiLity of oraL dissoLution therapy in the management of referred patients with secondariLy treated uric acid stones. Urology, 2002, 59(2): 206-210.
18. Калинина С.Н., Кореньков Д.Г., Мелконян А.Б. Опыт применения цитратной смеси Блемарен у больных с камнями мочеточников. Клиническая нефрология, 2013, 5: 30-32.
19. Глыбочко П.В., Аляев Ю.Г., Рапопорт Л.М. и др. Современная консервативная (цитратная) терапия при уратных камнях мочеточников. Урология, 2014, 5: 10-13.
20. Anderson EE, RundLes RW, SiLberman HR et aL. ALLopurinoL controL of hyperuricosuria: A new concept in the prevention of uric acid stones. J. Urol., 1967, 97: 344-347.
21. De Vries A, Frank M, Liberman UA et aL. ALLopurinoL in the prophyLaxis of uric acid stones. Ann. Rheum. Dis., 1966, 25: 691-693.
22. BLechman WJ, Rosenberg DG, HiLf P. Use of aLLopurinoL in gout, hyperuricemia and uric acid Lithiasis. South. Med. J., 1967, 60: 215-218.
Review
For citations:
Malkhasyan VA, Semenyakin IV, Ivanov VY, Popova AS. Conservative therapy of uric acid lithiasis: a review of literature. Meditsinskiy sovet = Medical Council. 2015;(4):92-95. (In Russ.) https://doi.org/10.21518/2079-701X-2015-4-92-95
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