Patients may be asymptomatic or present with renal colic, hematuria, infection, vomiting and renal failure.4 Although both intrinsic and environmental factors can contribute to urinary stone formation, the exact cause is still unclear.1 Multiple risk factors predispose patients to recurrence such as abnormal anatomy, family history of stone disease, environmental conditions and metabolic abnormalities such as hypercalciuria (35%), hyperoxaluria (19%), hypocitraturia (27%), hyperuricosuria
(18%), and a low urinary volume (56%).5 In majority of the cases of recurrent stones, thorough evaluation reveals metabolic abnormalities.
Brockis et al16 hyperuricosuria
and hyperuricemia were the most common metabolic changes and these conditions were more commonly observed in
Hypernatriuria was defined as a urinary sodium level greater than 220 mmol/day, hyperuricosuria
was defined as a urinary urate level greater than 750 mg/day and hypocitraturia was defined as a urinary citrate level less than 350 mg/day.
is characterized by the excretion of high levels of uric acid leading to urate stone formation.
Hence, calcium oxalate stones with small amounts of calcium phosphate are managed the same as calcium oxalate stones, by hydration and reduction of existing hypercalciuria, hyperoxaluria, hyperuricosuria
, and (or) hypocitraturia , whereas predominantly calcium phosphate calculi, which occur in renal tubular acidosis or hyperparathyroidism , may require definitive management.
Other causes of kidney stones are hyperuricosuria
(a disorder of uric acid metabolism), gout, excess intake of vitamin D, and blockage of the urinary tract.
Metabolic abnormalities causing, an equity of the promoters and inhibitors such as hypercalciuria, hyperoxaluria, hyperuricosuria
and hypocitruria have been considered as major metabolic risk for the formation of urinary stones.
We examined the percentage of patients with hypercalciuria (>260 mg/24-h), hyperoxaluria (>40 mg/24-h), hypocitraturia (<320 mg/24-h), and hyperuricosuria
The physiological and environmental factors responsible for uric acid stones are persistent urine acidity, hyperuricosuria
and decreased urine volume.
From 586 observed children the hyperoxaluria was revealed in 83.1% of patients; in 51.7% of cases it was found in combination with hyperuricosuria
* Allopurinol is effective for some cases of hypercalciuria and hyperuricosuria
They should restrict dietary purine, if they have hyperuricosuria
. Sodium restriction is also important because sodium increases urinary calcium.