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Urine Uric Acid

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101. Uric Acid Stones (Follow-up)

processing > Uric Acid Stones Follow-up Updated: Jun 11, 2018 Author: Sahar Fathallah-Shaykh, MD; Chief Editor: Craig B Langman, MD Share Email Print Feedback Close Sections Sections Uric Acid Stones Follow-up Further Outpatient Care The child should continue a low-purine diet if prescribed. Continue Bicitra (2-6 mEq/kg/d) for urinary alkalinization. Parents can be provided urine dipsticks to monitor urine pH level and specific gravity to assess the adequacy of treatment. Urine pH levels should (...) be maintained above 7. Urine specific gravity should be maintained below 1.01. Fluid intake should be sufficient to maintain urine output of 30 mL/kg/24h or more. Allopurinol is continued to lower uric acid production if prescribed. Children with urinary tract uric acid stones and/or urinary tract anatomic abnormalities or a previous urinary tract infection may require urinary tract infection uroprophylaxis. Next: Further Inpatient Care See the list below: Inpatient care is indicated for management of renal

2014 eMedicine Pediatrics

102. Uric Acid Stones (Treatment)

Stones Treatment & Management Updated: Jun 11, 2018 Author: Sahar Fathallah-Shaykh, MD; Chief Editor: Craig B Langman, MD Share Email Print Feedback Close Sections Sections Uric Acid Stones Treatment Medical Care The primary treatments are to alkalinize (citrate or bicarbonate) and dilute (large water intake) the urine. Sodium urate is 15 times more soluble than uric acid. At a urine pH level of 6.8, 10 times as much sodium urate as uric acid is present. At a urine pH level of 7.8, 100 times as much (...) if necessary. A urine Gram stain may guide in the selection of antibiotic coverage. Consultation with a pediatric urologist should be obtained because surgery may be necessary to provide drainage. A child with acute pain and large stones (>0.3 cm) is likely to require lithotripsy or surgical stone removal. Analgesics and adequate hydration should be provided. For smaller stones or incidental stones, allowing time for the stone to pass is appropriate. The primary treatment for uric acid stones includes

2014 eMedicine Pediatrics

103. Uric Acid Stones (Overview)

precipitation in metastable urine concentrates (see ). Uric acid stones. The terms gouty nephropathy, urate nephropathy, and uric acid nephropathy are used to describe renal insufficiency due to uric acid precipitation within the renal tubules. Uric acid urolithiasis or uric acid kidney stones refer to development of a stone or calculus composed of significant amounts of urate in the renal pelvis, ureter, or bladder. Next: Pathophysiology Uric acid is a weak acid, with an ionization constant of acid (pK (...) in urine exceeds its solubility at the urine pH, uric acid changes from a compound dissolved in solution to an insoluble precipitate. Urate stones are formed by 1 of 3 general mechanisms: overproduction, increased tubular secretion, or decreased tubular reabsorption. Uric acid results as a relatively insoluble end-product of purine metabolism. The concentration of uric acid in plasma depends on dietary ingestion, de novo purine synthesis, and uric acid elimination by the kidneys and intestine. Normal

2014 eMedicine Pediatrics

104. Uric Acid Stones (Diagnosis)

precipitation in metastable urine concentrates (see ). Uric acid stones. The terms gouty nephropathy, urate nephropathy, and uric acid nephropathy are used to describe renal insufficiency due to uric acid precipitation within the renal tubules. Uric acid urolithiasis or uric acid kidney stones refer to development of a stone or calculus composed of significant amounts of urate in the renal pelvis, ureter, or bladder. Next: Pathophysiology Uric acid is a weak acid, with an ionization constant of acid (pK (...) in urine exceeds its solubility at the urine pH, uric acid changes from a compound dissolved in solution to an insoluble precipitate. Urate stones are formed by 1 of 3 general mechanisms: overproduction, increased tubular secretion, or decreased tubular reabsorption. Uric acid results as a relatively insoluble end-product of purine metabolism. The concentration of uric acid in plasma depends on dietary ingestion, de novo purine synthesis, and uric acid elimination by the kidneys and intestine. Normal

2014 eMedicine Pediatrics

105. Potassium Citrate is Better in Reducing Salt and Increasing Urine pH than Oral Intake of Lemonade: A Cross-Over Study (PubMed)

Potassium Citrate is Better in Reducing Salt and Increasing Urine pH than Oral Intake of Lemonade: A Cross-Over Study BACKGROUND Urine solute supersaturation leads to the formation of urinary tract caliceal stones. Many parameters can be involved in the supersaturation of solutes in urine, such as pH. Uric acid has pKa ≤5.5, and it is solubilized at pH ≥5.5. The objective of the study was to evaluate the effects of potassium citrate and lemonade supplementation in pediatric patients (...) with urolithiasis. MATERIAL AND METHODS A total of 126 children who had lower ureteral stones calculi and fragments with severe colic pain participated in this cross-over study. Children drank lemonade (2 mEq/kg/day citrate) in 3 divided doses for 5 days. After a 15-day washout period, children drank 2 mEq/kg/day of potassium citrate in 3 divided doses for 5 days. On the sixth of the day of individual intervention, a 24-h urine sample was collected and evaluated for pH, urine volume, citrate level, uric acid

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2018 Medical science monitor : international medical journal of experimental and clinical research

106. DKB114, A Mixture of Chrysanthemum Indicum Linne Flower and Cinnamomum Cassia (L.) J. Presl Bark Extracts, Improves Hyperuricemia through Inhibition of Xanthine Oxidase Activity and Increasing Urine Excretion (PubMed)

of DKB114, a CF, and CB mixture, and the underlying mechanisms in vitro and in vivo. DKB114 markedly reduced serum uric acid levels in normal rats and rats with PO-induced hyperuricemia, while increasing renal uric acid excretion. Furthermore, it inhibited the activity of xanthine oxidase (XOD) in vitro and in the liver in addition to reducing hepatic uric acid production. DKB114 decreased cellular uric acid uptake in oocytes and HEK293 cells expressing human urate transporter (hURAT)1 and decreased (...) the protein expression levels of urate transporters, URAT1, and glucose transporter, GLUT9, associated with the reabsorption of uric acid in the kidney. DKB114 exerts antihyperuricemic effects and uricosuric effects, which are accompanied, partially, by a reduction in the production of uric acid and promotion of uric acid excretion via the inhibition of XOD activity and reabsorption of uric acid. Therefore, it may have potential as a treatment for hyperuricemia and gout.

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2018 Nutrients

107. Urine xanthine crystals in tumor lysis syndrome. (PubMed)

converted to uric acid by xanthine oxidase because of febuxostat inhibition of this enzyme.Copyright © 2018. Published by Elsevier Inc. (...) Urine xanthine crystals in tumor lysis syndrome. Urine xanthine crystals are remarkably rare but can be observed by routine urine microscopy. We report the results of a 67-year-old man with T-cell-prolymphocytic leukemia whose urine contained xanthine crystals after chemotherapy and prophylactic administration of febuxostat. Accumulation of xanthine was due to tumor lysis syndrome causing a massive release of DNA. The metabolized DNA caused an increase of xanthine, which was not readily

2018 Urology

108. Urine changing from clear to milky-white. (PubMed)

Urine changing from clear to milky-white. After sedation with propofol a young man developed milky-white urine. Urinalysis showed a high concentration of uric acid crystals as being responsible. This phenomenon appears to be dose-dependent and is explained in this report. Since it is harmless and self-limiting no extensive analysis is needed when observed.

2018 Netherlands Journal of Medicine

109. Gout: Observations on the Effects of Drugs on Plasma Uric Acid and Urinary Uric Acid (PubMed)

Gout: Observations on the Effects of Drugs on Plasma Uric Acid and Urinary Uric Acid 14878356 2004 02 15 2018 12 01 0003-4967 10 3 1951 Sep Annals of the rheumatic diseases Ann. Rheum. Dis. Gout; observations on the effects of drugs on plasma uric acid and urinary uric acid. 353-8 KERSLEY G D GD MANDEL L L BENE E E eng Journal Article England Ann Rheum Dis 0372355 0003-4967 268B43MJ25 Uric Acid OM Gout metabolism Humans Uric Acid urine 5221:8602:157:398 GOUT/metabolism in URIC ACID/in urine

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1951 Annals of the Rheumatic Diseases

110. Renal ammonium excretion after an acute acid load: Blunted response in uric acid stone formers but not in patients with type 2 diabetes. (PubMed)

Renal ammonium excretion after an acute acid load: Blunted response in uric acid stone formers but not in patients with type 2 diabetes. Idiopathic uric acid nephrolithiasis is characterized by elevated urinary net acid excretion and insufficient buffering by ammonium, resulting in excessively acidic urine and titration of the relatively soluble urate anion to insoluble uric acid. Patients with type 2 diabetes have similar changes in urinary pH, net acid excretion, and ammonium in 24-h urine (...) on a fixed diet for 5 days, subjects were given a single oral acid load (50 meq ammonium chloride), and urine was collected hourly for 4 h. Uric acid stone formers had a lower ammonium excretory response to acute acid loading compared with diabetic and nondiabetic nonstone formers, suggesting that an ammonium excretory defect unique to uric acid stone formers was unmasked by the acid challenge. The Zucker diabetic fatty rat also did not show impaired urinary ammonium excretion in response to acute acid

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2013 American Journal of Physiology. Renal physiology

111. Screening of primary aldosteronism by clinical features and daily laboratory tests: combination of urine pH, sex, and serum K. (PubMed)

-to-severe hypertension, hypokalemia, serum Na minus Cl at least 40 mmol/l, serum uric acid 237.92 μmol/l or less (4.0 mg/dl), and urine pH (U-pH) at least 7.0, in consecutive outpatients newly diagnosed with hypertension. The diagnostic criteria of primary aldosteronism were plasma aldosterone concentration-to-plasma renin activity ratio [ARR, (ng/dl)/(ng/ml per h)] at least 20 and at least one positive result in four types of challenge tests.Of 130 patients, 24 were diagnosed with primary aldosteronism (...) Screening of primary aldosteronism by clinical features and daily laboratory tests: combination of urine pH, sex, and serum K. To develop and validate a scoring system for selection of patients who should proceed to endocrinologic examinations of primary aldosteronism in newly diagnosed hypertensive patients.A multivariate logistic regression analysis for primary aldosteronism was undertaken by use of seven possible primary aldosteronism markers, age less than 40 years, female sex, moderate

2017 Journal of Hypertension

112. Relative Supersaturation of 24-hour Urine and Likelihood of Kidney Stones. (PubMed)

Relative Supersaturation of 24-hour Urine and Likelihood of Kidney Stones. The relative supersaturation of calcium oxalate, calcium phosphate and uric acid is used clinically in kidney stone prevention. The magnitude of the association between relative supersaturation and stone risk requires further quantification.We performed a cross-sectional study using 24-hour urine collections from the NHS (Nurses' Health Study) I and II, and HPFS (Health Professionals Follow-up Study) cohorts to quantify (...) the association between the relative supersaturation of calcium oxalate, calcium phosphate and uric acid, and the likelihood of stone formation.The OR of being a stone former was 5.85 (95% CI 3.40-10.04) in NHS I, 6.38 (95% CI 3.72-11.0) in NHS II and 6.95 (95% CI 3.56-13.6) in HPFS for the highest category of calcium oxalate relative supersaturation compared with less than 1.0. The OR of being a stone former was 1.86 (95% CI 0.94-3.71) in NHS I, 4.37 (95% CI 2.68-7.10) in NHS II and 3.59 (95% CI 2.04-6.31

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2017 Journal of Urology

113. Can a Simplified 12-Hour Night Time Urine Collection Predict Urinary Stone Risk? (PubMed)

Can a Simplified 12-Hour Night Time Urine Collection Predict Urinary Stone Risk? To determine if there is correlation between nighttime 12-hour and traditional 24-hour urine collection in regard to chemistry values and the supersaturations of calcium oxalate, calcium phosphate, and uric acid for the metabolic evaluation of nephrolithiasis.Ninety-five patients were prospectively enrolled from 2013 to 2015. Patients >18 years of age who presented to a tertiary stone clinic and who would normally (...) be counseled for 24-hour urine collection were eligible for the study. Participants completed 24-hour urine collections twice, with each divided into 2 separate 12-hour collections. Day-time collection began after the first morning void and continued for 12 hours. The night collection proceeded for the next 12 hours through the first morning void.Forty-nine 24-hour samples from 35 patients met inclusion criteria and were included in the analysis. Overall, there was strong correlation between the night 12

2017 Urology

114. Effect of citrus-based products on urine profile: A systematic review and meta-analysis. (PubMed)

found to be consistent with our selection criteria. However, only 8 studies were included in quantitative analysis, due to data availability. The present study showed a higher increased in urine pH for citrus-based products (mean difference, 0.16; 95% CI 0.01-0.32) and urinary citrate (mean difference, 124.49; 95% CI 80.24-168.74) compared with a control group. However, no differences were found in urine volume, urinary calcium, urinary oxalate, and urinary uric acid. From subgroup analysis, we (...) Effect of citrus-based products on urine profile: A systematic review and meta-analysis. Background. Urolithiasis is a disease with high recurrence rate, 30-50% within 5 years. The aim of the present study was to learn the effects of citrus-based products on the urine profile in healthy persons and people with urolithiasis compared to control diet and potassium citrate.  Methods. A systematic review was performed, which included interventional, prospective observational and retrospective

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2017 F1000Research

115. CT-based Diagnosis of Visceral Obesity and Hepatic Steatosis is Associated with Low Urine pH. (PubMed)

CT-based Diagnosis of Visceral Obesity and Hepatic Steatosis is Associated with Low Urine pH. Uric acid nephrolithiasis is associated with an elevated visceral fat area in kidney stone formers. Hepatic steatosis has also been linked to visceral obesity and nephrolithiasis. We evaluated the association of noncontrast computerized tomography based diagnosis of visceral obesity and hepatic steatosis with 24-hour urine parameters and stone composition in kidney stone formers.A total of 98 kidney (...) ) and visceral fat area greater than 48% (OR 5.33) were associated with uric acid stones. Linear regression demonstrated that the percent of visceral fat area was associated with lower 24-hour urine pH (β-coefficient -0.438, p <0.0001).Noncontrast computerized tomography based diagnosis of visceral obesity is associated with low urine pH, high urinary sodium and uric acid stone formation. Hepatic steatosis is associated with low urine pH.Copyright © 2017 American Urological Association Education and Research

2017 Journal of Urology

116. Relationship between urine pH and abnormal glucose tolerance in a community‐based study (PubMed)

adjusted for age, body mass index, systolic blood pressure, triglycerides, high-density lipoprotein cholesterol, uric acid, creatinine and antidiabetic agent use showed significant associations between low urine pH and both high fasting plasma glucose and high glycated hemoglobin levels (P for trend = 0.0260, 0.0075) in men. Furthermore, after the same adjustments, prevalence rates of abnormal glucose tolerance (≥6.11 mmol/L and ≥6.99 mmol/L), increased significantly as urine pH levels decreased (P (...) Relationship between urine pH and abnormal glucose tolerance in a community‐based study The association between urine pH and abnormal glucose tolerance in men and women is unclear; therefore, we carried out a community-based, cross-sectional study to investigate sex-specific associations between these values, possible indicators of prediabetes and type 2 diabetes.We enrolled 4,945 Japanese individuals (2,490 men and 2,455 women), who had undergone annual health checkups. To investigate

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2017 Journal of Diabetes Investigation

117. A Study to Evaluate the Renal Protective Effect (Urine Albumin-to-Creatinine Ratio (UACR)), Efficacy and Safety of Ipragliflozin in Type 2 Diabetes Mellitus Patients With Albuminuria

Acid [ Time Frame: Baseline up to 24 weeks ] Test parameter Uric Acid shall be measured at the local laboratory Change from baseline in health status as measured through EuroQol 5 Dimension 5 Level Health State Utility Index (EQ-5D-5L) questionnaire [ Time Frame: Baseline up to 24 weeks ] The EQ-5D-5L Questionnaire consists of 5 domains: mobility, self-care, usual activities, pain/discomfort, anxiety/depression Change from baseline in health status as measured through EuroQol-Visual Analogue Scale (...) A Study to Evaluate the Renal Protective Effect (Urine Albumin-to-Creatinine Ratio (UACR)), Efficacy and Safety of Ipragliflozin in Type 2 Diabetes Mellitus Patients With Albuminuria A Study to Evaluate the Renal Protective Effect (Urine Albumin-to-Creatinine Ratio (UACR)), Efficacy and Safety of Ipragliflozin in Type 2 Diabetes Mellitus Patients With Albuminuria - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration

2017 Clinical Trials

118. Fasting Single-Spot Urine pH Is Associated with Metabolic Syndrome in the Japanese Population (PubMed)

uric acid and high-sensitivity C-reactive protein, estimated glomerular filtration rate, and smoking and drinking status). Using multiple logistic regression analyses, adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for MetS incidence were calculated across urine pH categories. Path analysis was used to determine the relationship between MetS and urine pH.Subjects with MetS had significantly lower urine pH (5.9 ± 0.7) than those without MetS (6.0 ± 0.7) (p < 0.001). Partial (...) Fasting Single-Spot Urine pH Is Associated with Metabolic Syndrome in the Japanese Population To investigate the relationship between urine pH and metabolic syndrome (MetS) and its components, while controlling for covariates.This cross-sectional study was conducted on 5,430 Japanese subjects (4,691 without MetS; 739 with MetS) undergoing health assessments. Partial correlation analysis and analysis of covariance were used for controlling confounding parameters (age, gender, levels of serum

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2017 Medical Principles and Practice

119. Prednisone in Uric Acid Lowering in Symptomatic Heart Failure Patients With Hyperuricemia (PUSH-PATH) Study. (PubMed)

Prednisone in Uric Acid Lowering in Symptomatic Heart Failure Patients With Hyperuricemia (PUSH-PATH) Study. Chronic drug interactions that exist between symptomatic congestive heart failure (CHF) therapy and pharmacologic agents used for hyperuricemia and gout are a challenging problem in clinical practice. Recent observational studies showed that prednisone can induce a potent diuresis and lower serum uric acid concentration (SUA) in CHF. We therefore designed a randomized study to compare (...) the effect of prednisone with allopurinol on SUA in symptomatic CHF patients with hyperuricemia.Thirty-four symptomatic CHF participants with hyperuricemia (≥ 565 μmol/L) were randomized to receive prednisone (1 mg/kg/d, orally) or allopurinol (100 mg, thrice daily, orally) for 4 weeks. The primary outcome measure was change from baseline in SUA. The secondary outcome measures were change from baseline in serum creatinine levels, estimated glomerular filtration rate, daily urine output, body weight, N

2013 The Canadian journal of cardiology

120. Who makes uric acid stones and why--observations from a renal stones clinic. (PubMed)

Who makes uric acid stones and why--observations from a renal stones clinic. Excessively acidic urine is the dominant factor in uric acid stone formation. Recent evidence implicating insulin resistance has revived interest in its causation. We reviewed data on uric acid stone formers attending a general stones clinic to find out whether this supports and adds to current concepts.A retrospective database study of 1504 stone formers investigated at the Southampton renal stones clinic from 1990 (...) and uric acid stone formers with diabetes, gout or ileostomies. The median urine pH of men with idiopathic calcium stones was 6.20, idiopathic uric acid stones 5.47, diabetes 5.68, gout 6.05, diabetes and gout 5.20 and ileostomy 5.10. Plasma urate was higher with gout and idiopathic uric acid stones. Urate excretion was increased in gout. Oxalate excretion was lower with idiopathic uric acid stones (new finding). Urine volume decreased and oxalate concentration increased with ileostomy.Uric acid stones

2013 Journal of Clinical Pathology

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