Medical dissolution offers alternative to surgery for UA stones

  • Gridley CM & al.
  • World J Urol
  • 27 Feb 2019

  • curated by Craig Hicks
  • Clinical Essentials
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Takeaway

  • Medical dissolution therapy may be an effective, noninvasive alternative to surgery for uric acid (UA) nephrolithiasis.

Why this matters

  • UA nephrolithiasis accounts for 10% of kidney stones in the United States.

Study design

  • Researchers reviewed the health records of patients with UA stones who were referred for surgery, but treated with dissolution therapy of potassium citrate (Urocit K), either alone or in combination with allopurinol (Zyloprim; N=21; mean age, 55.8 years; mean BMI, 43.7 kg/m2; mean aggregate stone burden, 30.9 mm; 62% men).
  • Funding: None disclosed.

Key results

  • 14 patients (67%) experienced complete resolution of nephrolithiasis.
  • 7 patients (33%) experienced partial reduction in stone burden, with a mean reduction of 68%.
  • 3 patients experienced complications (urinary tract infections, gastrointestinal upset with therapy, and throat irritation); 4 had stone recurrences after treatment.

Limitations

  • The study was retrospective and single-center, with a small sample size.