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Clincal Science Tips and tricks to survive in the Clinical Science, share your clinical rotaion and lot more

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Thumbs up know sth about Uric Acid Stone Formation beyond Davidson! - 26-09-2007, 03:55 AM

Uric Acid Stone Formation

What is uric acid?

Uric acid is a waste of protein metabolism. It is also present in large quantities in some foods. It causes problems because humans do not possess the enzyme to digest it to a soluble form. When uric acid precipitates it can cause kidney stones or gout. Gout is a problem where uric acid crystals deposit in the joints, causing a painful inflammatory response.

How do uric acid stones form?

Like any stone, uric acid stones form when too much uric acid is present in the urine to remain dissolved. Uric acid stones form quickly as there are no known inhibitors in human urine to cope with fluctuation in output. A short period of dehydration in a susceptible individual is enough to begin stone formation. A sudden uric acid load from food can also precipitate a new stone. This means that what you eat and drink directly affects your chance of developing stone.

So what do I do?

Drink enough - You need to pass a pale urine consistently. Because stones form quickly, a single hot day working in the garden could lead to a stone. Aim for the colour below;



Rather than this colour;



Drinking water is so effective that you can actually dissolve stones that have already formed.

Watch your diet - diet will have a major effect.There are two aspects to diet control. One is the acid in the diet, and the other is the concentration of uric acid in various foods;

Acid from food

Uric acid's solubility in urine is dependent on the pH, or acidity of the urine. At a pH of 7 (neutral), urine can dissolve 1000 times the amount of uric acid than at pH 5 (acidic). Most people who form frequent uric acid stones have an acidic urine. Urine becomes acidic in response to diet. Proteins are the greatest source of acid in the diet. After a meal high in protein conditions become ideal for stone formation. So avoid eating large amounts of meat at one sitting and drink plenty of fluids with your meal. Adding some foods which have an anti-acid effect into the meal can also help. Dairy products are foods of this type. If you are particularly at risk taking a one off dose of the alkalinization agents below can also help.

Uric acid in food

50% of the uric acid in the body comes from food. Below is a list of food high in uric acid;



Foods high in uric acid
Shellfish :Lobster, crayfish, prawns, mussels, oysters, crabs, scallops.
Organ meats: Liver, kidney, brains, sweetbreads
Red meat: Any red meat.
Vegetables: Peas, beans
Fish: Anchovies, mackerel, sardines, herring.


Limit Alcohol - Alcohol, especially in binges can cause an attack of gout or kidney stones. The effect of alcohol is to cause dehydration, which then increases the risk of uric acid precipitation. If you do drink alcohol, space your drinks with water to minimize the risks.

What can I get from my doctor?

Urinary alkalinization - as previously stated, the solubility of uric acid is pH dependent. If your urine is acidic (pH 5) it will dissolve a thousand times less uric acid than at pH 7. Alkalinization is usually reserved as a treatment to dissolve away stones that have already formed. Either bicarbonate of soda or citrate are used. The aim is to raise the pH of the urine to the range 6.5 - 7. The amount of citrate or bicarbonate required varies from person to person. You will be asked to monitor the acidity of the urine with a simple dipstick test. When you know how much to take you should remain on his dose until the stone has gone. It is important not to take too much as raising the pH over 7 increases the risk of calcium stones forming. Remember, water has a pH of 7 so, the more you drink, the more likely you are to achieve the right level of acidity.

It is not unreasonable to take a dose of citrate or bicarbonate after a meal high in uric acid. This should not be seen as an effective way to eat lots of shellfish and brains.

Allopurinol - is a xanthine oxidase inhibitor. This enzyme is involved in a key step in the formation of uric acid. If you are shown to have a high uric acid level in the blood, then you may be recommended this tablet. It can be very effective in preventing recurrent stones where the cause is not related to diet or poor fluid intake. It is well tolerated, as a whole, with the main side effects being a rare skin rash and possible altered liver function. It is taken in a once a day dose of between 100 - 600mg.

So in summary -


Drink enough water
Limit your protein intake
Don't eat too much uric acid
Avoid excessive alcohol
Check your uric acid level in the blood


Remember that what you do in terms of drinking and eating can have a big impact in this condition, unlike many others. Most uric acid stones are preventable... this is up to you.


ki kaso??


छेऊमा पाए घचेट्ने कुनोमा पाए अँचेट्ने कहिल्यै नगर्नू

Last edited by SPRimal : 27-09-2007 at 04:28 AM.
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Re: know sth about Uric Acid Stone Formation beyond Davidson! - 04-10-2007, 02:29 AM

nice post mitra .
keep it up.


better heart 4 better nepal
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Re: know sth about Uric Acid Stone Formation beyond Davidson! - 25-12-2007, 01:17 AM

But i've one question. There are lot of conflicts that Can the beans and cereals aggravate uric acid formation. they say that the source of plants lack the purine so how can they form uric acid but i'm in doubt what really is the thing? so can anyone sort the problem....


Samrat Shrestha
4th Batch,

N.M.C.T.H
Birgunj,Nepal

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