Current Opportunities of Litholytic Therapy in Multiple Bilateral Uric Acid Nephrolithiasis

Uric acid urolithiasis accounts for approximately 10% of all urostone cases worldwide, with a higher risk in male patients, obesity (body mass index > 30) and type 2 diabetes. Excessive intake of dietary acids combined with impaired buffering are risk factors that contribute to the formation of kidney stones in these patients. When the level of uric acid in the blood increases and the pH of urine decreases, an excess of uric acid occurs, which leads to the formation of urate stones. The American and European Urological Associations recommend oral alkalinizers such as potassium citrate or sodium bicarbonate in the treatment to prevent the formation and induce dissolution of uric acid stones by increasing urine pH under dynamic control. Drugs are also actively used to reduce the level of uric acid in the blood. We present a clinical case of the effective use of litholytic therapy in a patient with multiple bilateral uric acid nephrolithiasis. For 2 months, the patient received a course of antiseptic and litholytic therapy with correction of the nutritional regime. The result of the treatment was complete litholysis of both kidney stones with a constant decrease of hyperuricemia, stabilization of urine pH in the range of 6.2–6.8 and the absence of bacterial growth in urine during of treatment.