Hyperuricosuric calcium urolithiasis

Orson W. Moe, Li Hao Richie Xu

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Hyperuricosuric calcium urolithiasis is a condition of mixed calcium oxalate stones characterized by hyperuricosuria either in isolation or in conjunction with other risk factors for calcium oxalate stones such as hypercalciuria, hyperoxaluria, and hypocitraturia. There are three proposed physicochemical models of pathogenesis where urate in its crystalline phase via heterogeneous nucleation, in its colloidal phase via removal of crystallization inhibitors, and in solution via precipitation crystallization, can all increase propensity to calcium oxalate precipitation. Regardless of the model, the phenomenologic observation of urate increasing calcium oxalate precipitation appears solid. Another supporting factor are retrospective data analysis and prospective trials showing uric acid lowering reduces stones events in hyperuricosuric calcium stone formers. Due to the heterogeneity of pathogenesis of calcium oxalate stones in the unselected stone-formers, association cannot be demonstrated between uric acid excretion rate and risk of kidney stone the general population. In calcium oxalate stoners with isolated hyperuricosuria or hyperuricosuria in combination with other calcium stone risks where treatment of these traditional risks fails to reduce stone formation, urate acid lowering should be cautiously attempted. More refinement of pathogenic models and prospective controlled trials in phenotypically defined subgroups of subjects with calcium oxalate urolithiasis will be informative.

Original languageEnglish (US)
Pages (from-to)1-8
Number of pages8
JournalJournal of Nephrology
DOIs
StateAccepted/In press - Jan 24 2018

Fingerprint

Calcium Oxalate
Urolithiasis
Uric Acid
Calcium
Crystallization
Hyperoxaluria
Hypercalciuria
Kidney Calculi
Observation
Acids
Population

Keywords

  • Calcium oxalate
  • Hyperuricosuria
  • Urolithiasis

ASJC Scopus subject areas

  • Nephrology

Cite this

Hyperuricosuric calcium urolithiasis. / Moe, Orson W.; Xu, Li Hao Richie.

In: Journal of Nephrology, 24.01.2018, p. 1-8.

Research output: Contribution to journalArticle

Moe, Orson W. ; Xu, Li Hao Richie. / Hyperuricosuric calcium urolithiasis. In: Journal of Nephrology. 2018 ; pp. 1-8.
@article{65e4c19cad3e47e5a1fa52ff658ad737,
title = "Hyperuricosuric calcium urolithiasis",
abstract = "Hyperuricosuric calcium urolithiasis is a condition of mixed calcium oxalate stones characterized by hyperuricosuria either in isolation or in conjunction with other risk factors for calcium oxalate stones such as hypercalciuria, hyperoxaluria, and hypocitraturia. There are three proposed physicochemical models of pathogenesis where urate in its crystalline phase via heterogeneous nucleation, in its colloidal phase via removal of crystallization inhibitors, and in solution via precipitation crystallization, can all increase propensity to calcium oxalate precipitation. Regardless of the model, the phenomenologic observation of urate increasing calcium oxalate precipitation appears solid. Another supporting factor are retrospective data analysis and prospective trials showing uric acid lowering reduces stones events in hyperuricosuric calcium stone formers. Due to the heterogeneity of pathogenesis of calcium oxalate stones in the unselected stone-formers, association cannot be demonstrated between uric acid excretion rate and risk of kidney stone the general population. In calcium oxalate stoners with isolated hyperuricosuria or hyperuricosuria in combination with other calcium stone risks where treatment of these traditional risks fails to reduce stone formation, urate acid lowering should be cautiously attempted. More refinement of pathogenic models and prospective controlled trials in phenotypically defined subgroups of subjects with calcium oxalate urolithiasis will be informative.",
keywords = "Calcium oxalate, Hyperuricosuria, Urolithiasis",
author = "Moe, {Orson W.} and Xu, {Li Hao Richie}",
year = "2018",
month = "1",
day = "24",
doi = "10.1007/s40620-018-0469-3",
language = "English (US)",
pages = "1--8",
journal = "Journal of Nephrology",
issn = "1121-8428",
publisher = "Wichtig Publishing",

}

TY - JOUR

T1 - Hyperuricosuric calcium urolithiasis

AU - Moe, Orson W.

AU - Xu, Li Hao Richie

PY - 2018/1/24

Y1 - 2018/1/24

N2 - Hyperuricosuric calcium urolithiasis is a condition of mixed calcium oxalate stones characterized by hyperuricosuria either in isolation or in conjunction with other risk factors for calcium oxalate stones such as hypercalciuria, hyperoxaluria, and hypocitraturia. There are three proposed physicochemical models of pathogenesis where urate in its crystalline phase via heterogeneous nucleation, in its colloidal phase via removal of crystallization inhibitors, and in solution via precipitation crystallization, can all increase propensity to calcium oxalate precipitation. Regardless of the model, the phenomenologic observation of urate increasing calcium oxalate precipitation appears solid. Another supporting factor are retrospective data analysis and prospective trials showing uric acid lowering reduces stones events in hyperuricosuric calcium stone formers. Due to the heterogeneity of pathogenesis of calcium oxalate stones in the unselected stone-formers, association cannot be demonstrated between uric acid excretion rate and risk of kidney stone the general population. In calcium oxalate stoners with isolated hyperuricosuria or hyperuricosuria in combination with other calcium stone risks where treatment of these traditional risks fails to reduce stone formation, urate acid lowering should be cautiously attempted. More refinement of pathogenic models and prospective controlled trials in phenotypically defined subgroups of subjects with calcium oxalate urolithiasis will be informative.

AB - Hyperuricosuric calcium urolithiasis is a condition of mixed calcium oxalate stones characterized by hyperuricosuria either in isolation or in conjunction with other risk factors for calcium oxalate stones such as hypercalciuria, hyperoxaluria, and hypocitraturia. There are three proposed physicochemical models of pathogenesis where urate in its crystalline phase via heterogeneous nucleation, in its colloidal phase via removal of crystallization inhibitors, and in solution via precipitation crystallization, can all increase propensity to calcium oxalate precipitation. Regardless of the model, the phenomenologic observation of urate increasing calcium oxalate precipitation appears solid. Another supporting factor are retrospective data analysis and prospective trials showing uric acid lowering reduces stones events in hyperuricosuric calcium stone formers. Due to the heterogeneity of pathogenesis of calcium oxalate stones in the unselected stone-formers, association cannot be demonstrated between uric acid excretion rate and risk of kidney stone the general population. In calcium oxalate stoners with isolated hyperuricosuria or hyperuricosuria in combination with other calcium stone risks where treatment of these traditional risks fails to reduce stone formation, urate acid lowering should be cautiously attempted. More refinement of pathogenic models and prospective controlled trials in phenotypically defined subgroups of subjects with calcium oxalate urolithiasis will be informative.

KW - Calcium oxalate

KW - Hyperuricosuria

KW - Urolithiasis

UR - http://www.scopus.com/inward/record.url?scp=85040907380&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85040907380&partnerID=8YFLogxK

U2 - 10.1007/s40620-018-0469-3

DO - 10.1007/s40620-018-0469-3

M3 - Article

SP - 1

EP - 8

JO - Journal of Nephrology

JF - Journal of Nephrology

SN - 1121-8428

ER -