Introduction
In 1776, it was a Swedish scientist named C.Scheele who identified that uric acid was the main component that is acidic in nature of the bladder stones. Renal stones have been a cause of pain and suffering throughout history, as there was no cure for them until recently. It was considered a severe condition with high-risk surgery as the treatment, which often resulted in a high mortality rate. Sir Issac Newton and Michelangelo were the famous historical figures who had this condition frequently.
What Is Uric Acid Stones?
Uric acid stones belong to a category of kidney stones. The mineral salts in the urine combine to form a hard stone called a renal stone. These stones might stay in the kidneys or move down to the ureter, which is very painful. When the stones do not move and remain in the kidneys are usually not painful or cause any other difficulty like urine obstruction, infections, or other health problems. Uric acid is a byproduct present in the bloodstream, resulting from the breakdown of a chemical known as purine. Purine is one of the chemicals that make up DNA or RNA. A significant portion of the uric acid from the blood is excreted through the urine. However, the excess stays in the body. This, in turn, leads to the formation of uric acid stones.
How Are Uric Acid Stones Formed?
Elevated levels of uric acid in the blood can lead to the formation of crystals. These crystals can combine with other chemicals in the body to form small hard masses. These masses keep on growing as the uric acid content rises. Sometimes they can join together to form a single colossal group. These stones can either stay in the kidneys or move to the ureter through the urinary bladder.
Very small stones can move through the urinary bladder without causing much pain. But if they do not travel down, they can increase in size and cause urine to be collected in the kidney (renal pelviectasis), ureter, bladder, or urethra. This can cause pain or other symptoms.
What Are the Causes of Uric Acid Stones?
Uric acid stones develop when
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Excessive levels of uric acid present within the body.
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The urine remains acidic for an extended period.
The reason behind high amounts of uric acid in the blood or acidic urine can include;
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A problem in Digesting Purines or Proteins in the Food: Digestive issues which make it difficult for the body to digest proteins or uric acid can be hereditary. Improper digestion of proteins or purines can result in uric acid level elevation in the bloodstream.
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Gout: This is another condition where the uric acid level in the blood is high. There can be deposition of uric acid crystals in joints, which causes joint pain.
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Food High in Purine: Beef, poultry, pork, eggs, fish, and such animal proteins are foods that contain high amounts of purines in them. Meats in organs like kidneys and liver contain the highest amounts of purines. Increased consumption of animal proteins rich in purines can cause the condition. Usually, a diet high in purines may not be the only reason for uric acid stones- they develop in people prone to the condition.
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Obesity: People who are obese can usually have uric acid stones as the increased uric acid levels in their blood are high.
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Diabetes: Those with diabetes can usually have uric acid stones as the increased uric acid levels in their blood are high.
Who Is at High Risk of the Condition?
People who drink less water are at a high risk of developing uric acid stones. Other people at risk include;
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Type 2 Diabetes.
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Increased consumption of salt and sugar.
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Family history of kidney stones.
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A sedentary lifestyle or those who do strenuous exercise.
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Those who undergo surgeries for weight loss(bariatric surgery).
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Some medications like immunosuppressants and diuretics.
What Are the Symptoms of Uric Acid Stones?
Stones that are not moving or are very small often do not cause problems. But larger stones can cause pain, obstruction of urine, sometimes infection, and other health problems. The symptoms commonly associated with uric acid stones can include;
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Pain that is severe in intensity on the sides of the lower back.
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Stomach pain that does not go away (with no associated digestive symptoms).
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Pain in the groin area.
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Hematuria (The presence of blood in urine).
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Vomiting.
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Fever.
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Chills.
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Foul-smelling urine.
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Urine that appears to be cloudy.
How Are Uric Acid Stones Diagnosed?
Diagnosis of uric acid stones can include;
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Blood Tests: Blood tests can reveal increased uric acid or calcium levels. Blood tests can assist in excluding alternative conditions that might be responsible for abdominal pain.
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Urine analysis: A urine analysis can also reveal increased calcium and uric acid levels.
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Imaging Tests: Imaging tests like computed tomography (CT) or ultrasound can help get details on the stone's location, size, etc of the stone. These can help to find even small rocks. Abdominal X-rays are not preferred as they might not show the smaller stones.
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Stone Analysis: The patient will be advised to urinate through a specialized filter to collect the stones or other sediments in urine. This will be sent to a laboratory to find the rock's chemical composition. This will give more details on the chemical composition of the stone and how it is formed. Hence it can provide clues on lifestyle modifications to prevent the further formation of stones.
How Are Uric Acid Stones Treated?
Stones less than 7mm are allowed to pass on their own. This can take about three weeks. Medications might be given to reduce uric acid levels in the blood, dissolve any already present stones and reduce urine acidity. Surgery might be required if the stone is big, obstruct the urine flow or cause any infection. Other treatment options can include;
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Shockwave Lithotripsy: This mode of treatment is non-invasive and uses high-energy sound waves to destroy the stones.
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Ureteroscopy: In this procedure, an endoscope is inserted into the bladder through the ureter. Smaller stones are removed, while larger stones might be broken using a laser before removal.
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Percutaneous Nephrolithotomy: This surgical procedure is usually performed for larger stones.
Conclusion
Drinking sufficient water daily can help to prevent this condition to an extent. It also helps reduce the urine concentration, making it lighter in color. Maintaining a healthy weight is yet another preventive measure. This can be done through regular exercise and following a healthy diet. Managing the salt intake and reducing animal proteins like beef, eggs, etc., can help to reduce the risk of uric acid stones.
