Abstract
Chronic urine acidification by fludrocortisone to treat infectious kidney stones
Highlights
Infectious urolithiasis accounts for 10 to 15% of all urinary stones [1]
Infectious stones may contain ammonium urate (AmUr), usually as a minor component, whose crystallization is promoted by alkaline pH and high concentration of ammonia [5,6]
We present the preliminary results obtained in three patients treated on a long term with fludrocortisone for urinary infectious stone
Summary
Infectious urolithiasis accounts for 10 to 15% of all urinary stones [1]. The development of infectionrelated urinary stones is promoted by alkaline urine. Chronic urinary tract infection by ureaseproducing bacteria increases pHu. The bacterial urease hydrolyses urea to produce ammonia and carbamate, carbamate rapidly hydrolysis to ammonia and carbonic acid. Urease activity increases thereby pHu, frequently above 7.0, promoting calcium phosphate supersaturation (apatite, pKa 6.8) and its crystallization in urine. Calcium phosphate stones promoted by urea-splitting bacteria frequently contain high amounts of carbonate due to increased bicarbonate concentration in urine [2]. Magnesium ammonium phosphate (struvite) is frequently identified in infectious stones. Infectious stones may contain ammonium urate (AmUr), usually as a minor component, whose crystallization is promoted by alkaline pH (pKa 7.95) and high concentration of ammonia (and urate) [5,6]
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