Edit concept Question Editor Create issue ticket

Urate Kidney Stone

Kidney Stone Analysis Results Urate (lab Test)


Presentation

  • In addition, axial skeletal pain (cervical spine, anterior chest, thoracic spine, or low back) must be present.[books.google.com]
  • Urine microscopic testing Blood indicates injury due to crystal passage Crystals indicate the possibility of a stone Urine culture – consider to evaluate for concomitant urinary tract infection CBC – especially if symptoms of concomitant infection are present[arupconsult.com]
  • […] symptoms are present, consult a doctor immediately.[americanaddictioncenters.org]
  • Strangury is also occasionally present. Some patients may also present with the complication of obstructive pyelonephritis, and may therefore have a septic clinical presentation.[radiopaedia.org]
Asymptomatic
  • Asymptomatic hyperuricemia: To treat or not to treat. Cleveland Clinic Journal of Medicine , vol. 69, no. 8, Pp 594-608. Available online at . Accessed October 2010.[labtestsonline.org]
  • Although some renal stones remain asymptomatic, most will result in pain. Small stones that arise in the kidney are more likely to pass into the ureter where they may result in renal colic.[radiopaedia.org]
  • Diagnosis Urinary tract infection Ectopic pregnancy Musculoskeletal pain Ovarian cyst rupture Ovarian torsion Peritonitis Prostatitis Acute pyelonephritis Interstitial cystitis Groin hernia Screening There is no evidence to support screening for stones in asymptomatic[arupconsult.com]
  • Symptoms Small kidney stones are generally asymptomatic and may be cleared through urine with little to no pain.[innerbody.com]
  • Optimal treatment of chronic asymptomatic hyperuricemia requires long-term reductions in serum UA levels.[journals.plos.org]
Weight Loss
  • Risk factors for developing kidney stones include: being over age 40, being male, ingesting too little water, too much/little exercise, obesity, weight loss surgery, digestive diseases, and consuming a diet high in salt, protein or sugar, especially fructose[foxnews.com]
  • Rapid weight loss can increase uric acid levels. Drink 8 to 12 cups of fluid every day to help reduce kidney stone formation. Don’t take baker’s or brewer’s yeast as a supplement.[share.upmc.com]
  • Fasting, rapid weight loss, stress, and strenuous exercise all raise uric acid levels. Although the uric acid test cannot definitively diagnose gout, a test for monosodium urate in synovial fluid (joint fluid) can.[labtestsonline.org]
Family History of Gout
  • history of gout or stones Malignancy treated with chemotherapy Diet high in purines Cystine 1-2% Hereditary cystinuria Clinical Presentation Acute, colicky flank pain radiating into the pelvis and genitalia Hematuria – present in 90% of patients Nausea[arupconsult.com]
  • It tends to run in some families, as there is a family history of gout in about 1 in 5 cases. It may be that the genetic makeup that you inherit from your family may be a factor in becoming an under-excreter of uric acid (urate).[patient.info]
  • Assess for a history of deficiency of these enzymes, family history of gout at a young age, renal stones with uric acid in other family members, or glycogen-storage disease. A previous history of painful gross hematuria is requested in the proband.[emedicine.medscape.com]
Soft Tissue Swelling
  • الصفحة 210 - At least three joint areas simultaneously have had soft tissue swelling or fluid (not bony overgrowth alone) observed by a physician. The 14 possible areas are right or left PIP, MCP, wrist, elbow, knee, ankle, and MTP joints... ‏[books.google.com]
Buttock Pain
  • In this definition, shoulder and buttock pain is considered as pain for each involved side, "low back" pain is considered lower segment pain. ‏[books.google.com]
Neglect
  • The Profligate Punished by Neglect, Edward Penny 1774 catches the common motif of diet excess, obesity, diabetes, and gout – the joint manifestations of uric acid crystals. Note the abdominal fat denoted by his overly tight vest.[kidneystones.uchicago.edu]
Hematuria
  • Tabs Content Clinical Overview Diagnosis Indications for Testing Hematuria Flank pain Colicky back pain Laboratory Testing Initial testing Urinalysis Point-of-care testing for hematuria Urine microscopic testing Blood indicates injury due to crystal passage[arupconsult.com]
  • Children with uric acid stones tend to have 1 of 3 types of presentations: (1) renal colic, gross hematuria, and infection; (2) renal colic with or without hematuria with one or more large stones or renal colic with or without hematuria with one or more[emedicine.medscape.com]
  • Blood in the urine (hematuria). Fever, nausea and/or vomiting may also be present. There is also an increased risk of urinary tract infections (UTIs). Most of the signs and symptoms overlap with kidney stone symptoms.[healthhype.com]
Flank Pain
  • Tabs Content Clinical Overview Diagnosis Indications for Testing Hematuria Flank pain Colicky back pain Laboratory Testing Initial testing Urinalysis Point-of-care testing for hematuria Urine microscopic testing Blood indicates injury due to crystal passage[arupconsult.com]
  • It is important to inquire about history of mysterious flank pain or renal colic-like symptoms that may not have been recognized as such.[cancertherapyadvisor.com]
  • It includes: Flank pain and/or back pain. Pain when urinating. Difficulty passing urine. Persistent urge to urinate. Abnormal urine volume evident as frequent urination or low volume urine output. Blood in the urine (hematuria).[healthhype.com]
  • Clinical Presentation The classic presentation of a renal stone is acute, colicky flank pain radiating to the groin or scrotum, often associated with nausea and vomiting.[auanet.org]
  • Flank pain radiating to the groin, building to a maximum in half an hour and extreme in severity, is typical. Renal failure is unusual; it is associated with bilateral obstruction, staghorn stones, or some causes of nephrocalcinosis.[consultant360.com]
Macroscopic Hematuria
  • Most patients experience microscopic or macroscopic hematuria from ureteral or renal pelvis irritation.Renal colic pain often starts at night or in early morning hours, sometimes awakening the sufferer from sleep, and increasing in intensity over 30 min[cancertherapyadvisor.com]
Incontinence
  • Low urine volume may be due to hot climate or occupation, diarrheal disease or ileostomy, urological disease (incontinence or frequency) with tendency to limit fluid intake, or low intake due to social and cultural factors. Hypercalciuria.[consultant360.com]

Workup

  • The first kidney stone in a child prompts a more complete workup.[arupconsult.com]
  • As part of his visible haematuria workup 4 years ago, a 66-year-old gentleman with a history of gout was found to have a horseshoe kidney.[jeleu.com]
  • Necessary workup includes a midstream clean catch or catheterized urine specimen for urinalysis and microscopy with urine culture as indicated, CBC to assess for leukocytosis, and creatinine to assess for any rise above the patient’s baseline.[auanet.org]
Ammonia Increased
  • As ammonia increases urine pH can rise despite loss of alkali and the higher pH would favor the ammonium acid urate salt. Changes in Urine pH In principle, potassium alkali in the proper dose will raise urine pH and abolish uric acid formation.[kidneystones.uchicago.edu]
Treponema Pallidum
  • الصفحة 559 - IgM anti-cardiolipin antibodies, (2) a positive test result for lupus anticoagulant using a standard method, or (3) a false-positive serologic test for syphilis known to be positive for at least 6 months and confirmed by Treponema pallidum[books.google.com]

Treatment

  • One or more of the following diagnoses and treatments may be made based on these metabolic data.[hopkinsmedicine.org]
  • For stones in the kidney, shock wave lithotripsy (SWL) is the most common treatment. SWL treatment cannot be used in everyone. For patients who are pregnant, morbidly obese, or have a blood clotting disorder, ureteroscopy is a good choice.[kidney.org]
  • So treatment is not as transparent as for uric acid.[kidneystones.uchicago.edu]
  • The treatment of uric acid stones consists not only of hydration (urine volume above 2000 ml daily), but mainly of urine alkalinization to pH values between 6.2 and 6.8.[ncbi.nlm.nih.gov]
  • Treatment Options Deciding on a treatment plan for your kidney stones can depend upon a variety of factors such as their type, location and size.[cblpath.com]

Prognosis

  • […] but they may include: Drinking extra water and other liquids Eating more of some foods and cutting back on other foods Taking medicines to help prevent stones Taking medicines to help you pass a stone (anti-inflammatory drugs, alpha-blockers) Outlook (Prognosis[slu.adam.com]
  • Treatment and prognosis Indications for surgical management include: larger stones, typically those above 5mm in size extended duration of symptoms location of stone, with proximal calculi less likely to spontaneously pass infection or septic features[radiopaedia.org]
  • What is the outcome (prognosis)? A sudden-onset (acute) attack of gout usually resolves within 3-10 days. About 2 in every 3 people who have one acute attack will have another acute attack within the following year.[patient.info]
  • Although dRTA generally coincides with a more severe nephrocalcinosis than in Dent's disease, patients with the former have a better prognosis in terms of renal function: ESRD reportedly occurred in only 3% of patients during a follow-up of 12 years,[academic.oup.com]

Etiology

  • The presence of mixed stones suggests a multi factorial etiology.[alliedacademies.org]
  • Uric acid Hyperuricosuria is not always associated with hyperuricemia and is seen in a variety of settings (see above), although in most instances uric acid stones occur in patients with no identifiable underlying etiology 6 .[radiopaedia.org]
  • The etiology of idiopathic hypercalciuria involves one or more of the following events: enhanced intestinal calcium absorption, reduced renal tubular absorption, increased calcium mobilization from bone, and renal phosphate leak.[consultant360.com]
  • If patient is older with unclear etiology of abdominal pain, assess for abdominal aortic aneurysm. E. What diagnostic tests should be performed? Non-contrast computed tomography (CT) of the abdomen is the gold standard.[cancertherapyadvisor.com]
  • Urinary calculi: review of classification methods and correlation with etiology. Scan Microsc. 1993;7(3):1081-106. [ Links ] 8. Djelloul Z, Djelloul A, Bedjaoui A, Kaid-Omar Z, Attar A, Daudon M, Addou A.[scielo.br]

Epidemiology

  • […] urine – kidney stone panel testing Should include testing for calcium oxalate, sodium, uric acid, citric acid, phosphorus, creatinine Quantitative cystine in patients with cystinuria Serum – urea nitrogen, creatinine, and ionized calcium Background Epidemiology[arupconsult.com]
  • Changes in stone composition according to age and gender of patients: A multivariate epidemiological approach. Urol Res 2004; 32: 241-7. Daudon M. Epidemiology of nephrolithiasis in France. Ann Urol 2005; 39: 209-31.[alliedacademies.org]
  • Epidemiology and clinical pathophysiology of uric acid kidney stones. J Nephrol 2014;27(3):241–45. 15. Maalouf NM. Metabolic syndrome and the genesis of uric acid stones. J Renal Nutrit . 2011;21(1):128–31. 16.[jeleu.com]
  • Epidemiologic data show that these two stone types comprise 67%–90% of all renal stones ( 11 ). The clinical management of urinary tract stones depends on the location, size, and number of calculi, as well as their chemical composition.[pubs.rsna.org]
  • Choi HK, Curhan G: Gout: epidemiology and lifestyle choices . Curr Opin Rheumatol 2005, 17: 341–345. PubMed CrossRef Google Scholar 8.[link.springer.com]
Sex distribution
Age distribution

Pathophysiology

  • PAK Major progress has been made in the pathophysiologic elucidation and management of nephrolithiasis during the past two decades.[books.google.com]
  • Hypocitraturia: pathophysiology and medical management. Rev Urol. 2009 Summer;11(3):134-44. Oussama A1, Touhami M, Mbarki M. In vitro and in vivo study of effect of lemon juice on urinary lithogenesis. Arch Esp Urol. 2005 Dec;58(10):1087-92.[globalhealingcenter.com]
  • Epidemiology and clinical pathophysiology of uric acid kidney stones. J Nephrol 2014;27(3):241–45. 15. Maalouf NM. Metabolic syndrome and the genesis of uric acid stones. J Renal Nutrit . 2011;21(1):128–31. 16.[jeleu.com]
  • Moe OW, Abate N, Sakhaee K: Pathophysiology of uric acid nephrolithiasis . Endo Clin North Am 2002, 31: 895–914. CrossRef Google Scholar 20. Mount DB, Kwon C, Zandi-Nejad K: Renal urate transport .[link.springer.com]
  • PATHOPHYSIOLOGY OF STONE FORMATION Calcium stone formation begins with formation of calcium phosphate deposits (Randall plaques) on the external urothelial surface of the papilla.[consultant360.com]

Prevention

  • It is now possible to detect the cause of stone disease in more than 95% of patients, to prevent recurrent formation of stones in the majority of patients, and to remove most existing stones less invasively.[books.google.com]
  • Medications that prevent the urine from becoming too acidic help prevent uric acid stones.[secondopinion-tv.org]
  • Passing a kidney stone would qualify for one of life’s “lemons,” but did you know that drinking lemonade has been shown to prevent them? Drinking lemonade is one of five ways you can prevent kidney stones, according to Roger L.[health.ucsd.edu]
  • Also, some evidence suggests that citrate may prevent crystals that are already present from binding with each other, thus preventing them from getting bigger.” Dr.[diabetesselfmanagement.com]
  • Also, some evidence suggests that citrate may prevent crystals that are already present from binding with each other, thus preventing them from getting bigger.[kidney.org]

Ask Question

5000 Characters left Format the text using: # Heading, **bold**, _italic_. HTML code is not allowed.
By publishing this question you agree to the TOS and Privacy policy.
• Use a precise title for your question.
• Ask a specific question and provide age, sex, symptoms, type and duration of treatment.
• Respect your own and other people's privacy, never post full names or contact information.
• Inappropriate questions will be deleted.
• In urgent cases contact a physician, visit a hospital or call an emergency service!