Uric acid nephrolithiasis can be treated and prevented by reversing its causes.
(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.
(1) abstinence from alcohol (especially beer)
(2) avoid becoming dehydrated
(3) reduce body weight if obese
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Specialty: Nephrology, Clinical Laboratory