Uric Acid Stones Follow-up

Updated: Jun 11, 2018
  • Author: Sahar Fathallah-Shaykh, MD; Chief Editor: Craig B Langman, MD  more...
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Follow-up

Further Outpatient Care

The child should continue a low-purine diet if prescribed.

  • Continue Bicitra (2-6 mEq/kg/d) for urinary alkalinization.

  • Parents can be provided urine dipsticks to monitor urine pH level and specific gravity to assess the adequacy of treatment. Urine pH levels should be maintained above 7. Urine specific gravity should be maintained below 1.01.

  • Fluid intake should be sufficient to maintain urine output of 30 mL/kg/24h or more.

  • Allopurinol is continued to lower uric acid production if prescribed.

Children with urinary tract uric acid stones and/or urinary tract anatomic abnormalities or a previous urinary tract infection may require urinary tract infection uroprophylaxis.

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Further Inpatient Care

See the list below:

  • Inpatient care is indicated for management of renal failure, urologic surgery, severe pain, infection, or obstruction.

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Inpatient & Outpatient Medications

See the list below:

  • A low-purine diet, allopurinol, Bicitra, and aggressive hydration should be continued. The goals are to dissolve present stones and to prevent new stones.

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Deterrence/Prevention

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  • A low-purine diet, urinary alkalinization, and large fluid intake may prevent new stones from forming.

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Complications

Complications of renal stone disease include the following:

  • Bleeding

  • Obstruction

  • Infection

  • Pain

  • Complications of acute renal failure (ie, hypertension, hyperkalemia, pulmonary edema)

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Prognosis

See the list below:

  • The prognosis depends on the primary disease process. Children with cancer and Lesch-Nyhan syndrome tend to do worse than children with isolated HGPRT defects.

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Patient Education

See the list below:

  • Inform patients about the specific disease process when possible.

  • Discuss the importance of diet, medication, and fluid intake in preventing new stone formation.

  • Indicate the importance of physician reevaluation if the child develops fever, pain, vomiting, dehydration, renal colic, or gross hematuria.

  • For excellent patient education resources, see eMedicineHealth's patient education article Kidney Stones.

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