In total, uric acid stones account for 10-15% of all types of kidney stones in the population, but this figure increases to 60% in patients with diabetes mellitus. The incidence rate for urate nephrolithiasis varies from 5 to 40% in different countries. The classic risk factors for the development of uric acid stones in the kidneys are hyperuricemia, decreased urine output and acidic urine.
Find out in the article on estet-portal.com why the level of uric acid rises and what approaches to the treatment of this condition exist.
- hyperuricemia as a risk factor for the development of urate nephrolithiasis
- mechanisms of kidney injury in hyperuricemia
- basic approaches to the treatment of hyperuricemia and its consequences
Hyperuricemia as a risk factor for the development of urate nephrolithiasis
As a result of an increase in the concentration of uric acid in the blood plasma, its excretion in the urine (hyperuricosuria) also increases, so hyperuricemia is directly related to the development of urate nephrolithiasis.
Follow us on Instagram!
Uric acid nephrolithiasis is more common in patients with diabetes mellitus, obesity, or metabolic syndrome compared with patients without such diseases.
Acute cystitis: a common female problem
This pattern is explained by the fact that the aforementioned pathological conditions are characterized by an excessively acidic reaction of urine, which leads to precipitation and crystallization of uric acid. The presence of calculi in the kidneys leads to difficulty in the outflow of urine, which causes the development of chronic inflammation and, as a result, the progression of chronic kidney disease, especially in patients with concomitant diseases accompanied by one or another lesion urinary system.
Mechanisms of kidney damage in hyperuricemia
To risk factors for the development of uric acid nephrolithiasis include: diseases and conditions associated with the development of hyperuricemia and subsequent hyperuricosuria, genetically determined enzymopathies (primary gout), increased breakdown of cell DNA (massive tissue damage, tumor processes, lymphoproliferative diseases), B12 deficiency anemia, nutritional habits; taking medicines (salicylates, diuretics, cytostatics, etc.), prolonged fasting; excessive physical activity; diseases and conditions accompanied by low urine pH.
Kidney lesions in systemic lupus erythematosus: drug therapy
General recommendations for the treatment of hyperuricemia include: weight loss in obese patients; increasing physical activity limiting the intake of protein products of animal origin (meat, fish and poultry) at a daily rate of 0.8 g / kg / day and replacing them with fresh fruits and vegetables; exclusion of alcohol consumption; drinking enough fluids; treatment and compensation of concomitant diseases.
Basic approaches to the treatment of hyperuricemia and its consequences
As the acidity of the urine increases, the level of soluble urates increases and the level of uric acid decreases. Citrate therapy is recommended when attempting to dissolve urate stones and in patients undergoing shock wave lithotripsy to dissolve residual fragments after the procedure.
Citrate therapy has a potential hazardous effect of hyperkalemia and therefore should be used with caution in patients with diabetes, in patients taking ACE inhibitors, mineralocorticoid receptor antagonists, and in individuals with reduced glomerular filtration rate. It is necessary to monitor the level of potassium in the blood serum after 2-4 weeks from the start of treatment.
What men fear: diagnosis and treatment of orchiepidymitis
As noted above, in order to prevent the manifestation and progression of diseases associated with the state of hyperuricemia, it is important to start antihyperuricemic therapy on time and correctly. An increase in the level of uric acid in the blood followed by hyperuricosuria, which is combined with a low pH level urine and reduced diuresis, ─ the basis of the pathogenesis of urate nephrolithiasis.
Why does urethral stricture occur and how to treat it
Allopurinol ─ the first developed xanthine oxidase inhibitor, which has been used for a long time to correct hyperuricemia. However, this drug has a number of disadvantages, in particular such adverse reactions as reactive attacks of gout, vasculitis, hepatitis, progressive renal failure, etc. which is associated with a decrease in the concentration of uric acid in the blood serum by a powerful selective inhibition of xanthine oxidase. More useful information on our
YouTube channel: