Therapeutic target
Prevention of stone recurrence (recurrence of urinary stones).
Therapy recommendations
Note: The formation optimum of ammonium urate stones tends to be in the neutral range (pH > 6.5), in contrast to uric acid stones.
Reduction of risk factors
- Behavioral risk factors
- Dehydration (dehydration of the body due to fluid loss or lack of fluid intake).
- Malnutrition (malnutrition)
- Disease-related risk factors
- Chronic diarrhea (diarrhea)
- Malabsorption syndromes (diseases caused by impaired absorption of substrates from the intestine).
- Urinary tract infections
- Medication
- Laxative abuse (misuse of laxatives) with concomitant hyperchloremic metabolic acidosis
Nutritional therapy
- Fluid intake 2.5-3 l / day
Agents or measures of metaphylaxis.
- Complete removal of the infectious stone mass from the hollow system (if present).
- Treatment of the urinary tract infection with a tested antibiotic (resistogram!).
- L-methionine or ammonium chloride for urine acidification (setting an acid urine pH between 5.8-6.2).
- Hyperuricosuria (increased excretion of uric acid with the urine) is treated with allopurinol (drug for the treatment of chronic gout).