Guidelines
Guidelines Summary
The American Urological Association (AUA) guidelines for medical management of kidney stones include the following treatment recommendations relevant to hyperuricosuria [9] :
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Fluid intake should be sufficient to achieve a urine volume of at least 2.5 liters daily.
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Patients with uric acid stones or calcium stones and relatively high urinary uric acid should limit intake of non-dairy animal protein.
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Allopurinol should be offered to to patients with recurrent calcium oxalate stones who have hyperuricosuria and normal urinary calcium, but should not routinely be offered as first-line therapy for uric acid stones.
The European Association of Urology (EAU) guidelines for urolithiasis make the following recommendations for the treatment of hyperuricosuria [10] :
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First-line treatment is allopurinol
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Second-line treatment is febuxostat
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Excess intake of animal protein should be avoided
Media Gallery
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CT scan demonstrating right partial staghorn uric acid calculus. Uric acid stones appear dense on CT scan and radiolucent on kidneys, ureters, and bladder (KUB) imaging (not shown).
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Follow-up CT scan of patient in the image above (ie, with partial staghorn uric acid calculus) 1 year later. This patient was treated with oral urinary alkalinization with sodium bicarbonate. Note only a small residual fragment is present (right image).
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