Uric acid nephrolithiasis can be treated and prevented by reversing its causes.


Therapeutic goals:

(1) alkalinize the urine

(2) reduce intake of purines

(3) reduce excretion of uric acid

(4) dilute the urine with fluid intake of 2.5 to 3 liters per day


The goal of urine alkalinization is a pH 7.0 to 7.2

(1) sodium bicarbonate or mineral water with a high concentration of bicarbonate

(2) potassium citrate or potassium+sodium citrate

(3) citrus juices

(4) calcium citrate if renal function is reduced


Reduced intake of purine-rich food:

(1) avoid meat, fish, yeast and other foods high in purine

(2) eat vegetables, cereal products, fruit, eggs and dairy products (ova-lacto-vegetarian diet)


Allopurinol is used to reduce uric acid excretion in the urine to < 4 mmol per day.


Since urine tends to become concentrated during sleep, fluid should be taken before going to bed and before each voiding at night.


Additional interventions:

(1) abstinence from alcohol (especially beer)

(2) avoid becoming dehydrated

(3) reduce body weight if obese


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