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Saturation levels of uric acid in blood may result in one form of kidney stones when the urate crystallizes in the kidney. These uric acid stones are radiolucent, so do not appear on an abdominal plain X-ray. [57] Uric acid crystals can also promote the formation of calcium oxalate stones, acting as "seed crystals". [58]
By decreasing plasma uric acid levels, help dissolve these crystals, while limiting the formation of new ones. However, the increased uric acid levels in urine can contribute to kidney stones. Thus, use of these drugs is contraindicated in persons already with a high urine concentration of uric acid (hyperuricosuria). In borderline cases ...
Dosage is adjusted to maintain a reduced urinary excretion of uric acid. Serum uric acid level at or below 6 mg/100 mL is often a therapeutic goal. Hyperuricemia is not necessary for the formation of uric acid stones; hyperuricosuria can occur in the presence of normal or even low serum uric acid.
It is also used to increase urine pH (alkalinize urine) - this prevents uric acid stones and cystine stones (which form in cystinuria). [2] It is different from citric acid which is citrate bonded by hydrogen ions (or protons) making it acidic. [3] Citric acid does not alkalinize urine as alkali citrate does. [4]
[20] [64] Probenecid may be used if undersecretion of uric acid is present (24-hour urine uric acid less than 800 mg). [75] It is, however, not recommended if a person has a history of kidney stones. [75] Probenecid can be used in a combined therapy with allopurinol is more effective than allopurinol monotherapy. [76] [77] [78]
In kidney stones, calcium oxalate is the most common mineral type (see nephrolithiasis). Uric acid is the second most common mineral type, but an in vitro study showed uric acid stones and crystals can promote the formation of calcium oxalate stones. [1]
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