Hyperuricosuria and Gouty Diathesis Guidelines

Updated: Jan 26, 2022
  • Author: Bijan Shekarriz, MD; Chief Editor: Bradley Fields Schwartz, DO, FACS  more...
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Guidelines Summary

The American Urological Association (AUA) guidelines for medical management of kidney stones include the following treatment recommendations relevant to hyperuricosuria [9] :

  • Fluid intake should be sufficient to achieve a urine volume of at least 2.5 liters daily. 
  • Patients with uric acid stones or calcium stones and relatively high urinary uric acid should limit intake of non-dairy animal protein. 
  • 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] :

  • First-line treatment is allopurinol
  • Second-line treatment is febuxostat
  • Excess intake of animal protein should be avoided