Oral Dissolution Therapy of Uric Acid Stones: A Systematic Review

Abstract

Background/Objectives: Uric acid stones are the second most common type of kidney stones worldwide. Despite being cost-effective and widely available, pharmacological management for these stones is less utilized compared to surgical approaches. Therefore, we conducted a systematic review of the literature to assess the efficacy and shortcomings of oral dissolution therapy for uric acid stones. Methods: Embase, Scopus, PubMed, and Cochrane library databases were searched for English language studies on adults who were diagnosed with uric acid kidney stones and treated with oral dissolution therapy. Results: Twelve studies met our inclusion criteria. Potassium citrate was the primary agent used for dissolution in 10 of the studies and demonstrated a 50% or higher success rate for complete dissolution of uric acid stones. Treatment time for successful dissolution varied, with an average of 3 months minimum and an average of 2.78 years maximum. Overall, 11 of the studies recommended that oral dissolution therapy should be used for either treatment or prevention of uric acid stones. Conclusions: The available evidence demonstrates benefit of oral dissolution therapy for patients with uric acid stones. However, future rigorous studies are required to determine the optimal treatment regimen.

Keywords

• uric acid
• urolithiasis
• oral dissolution therapy
• potassium citrate
• sodium bicarbonate