{"id":10230,"date":"2026-06-03T20:00:00","date_gmt":"2026-06-03T13:00:00","guid":{"rendered":"https:\/\/drsoaraweeurology.com\/?p=10230"},"modified":"2026-05-04T22:29:29","modified_gmt":"2026-05-04T15:29:29","slug":"uric-acid-kidney-stones-case-study","status":"publish","type":"post","link":"https:\/\/drsoaraweeurology.com\/ru\/2026\/06\/03\/uric-acid-kidney-stones-case-study\/","title":{"rendered":"The Silent Architect of Stones: Navigating Uric Acid Kidney Disease"},"content":{"rendered":"\n<div class=\"wp-block-columns coblocks-author-columns has-background is-layout-flex wp-container-core-columns-is-layout-e269d6e6 wp-block-columns-is-layout-flex\" style=\"background-color:#8C8C971A;padding-top:2.5rem;padding-right:2.5rem;padding-bottom:2.5rem;padding-left:2.5rem\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:25%\">\n<figure class=\"wp-block-image size-full is-style-rounded\"><img data-recalc-dims=\"1\" fetchpriority=\"high\" 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Thailand&lt;\/p&gt;\n\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?fit=800%2C800&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?resize=800%2C800&#038;ssl=1\" alt=\"Dr. Soarawee Weerasopone \u2014 Board-Certified Urologist in Bangkok, Thailand\" class=\"wp-image-7037\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?w=800&amp;ssl=1 800w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?resize=300%2C300&amp;ssl=1 300w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?resize=150%2C150&amp;ssl=1 150w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?resize=768%2C768&amp;ssl=1 768w, 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href=\"https:\/\/scholar.google.com\/citations?user=lTgsRMUAAAAJ&#038;hl=en\" \n     target=\"_blank\" \n     rel=\"noopener\"\n     title=\"Google Scholar\"\n     aria-label=\"View Google Scholar Profile\"\n     style=\"text-decoration: none; color: #4285F4; transition: transform 0.2s; display: inline-block;\"\n     onmouseover=\"this.style.transform='scale(1.15)'\"\n     onmouseout=\"this.style.transform='scale(1)'\">\n    <svg width=\"28\" height=\"28\" viewBox=\"0 0 24 24\" fill=\"currentColor\">\n      <path d=\"M5.242 13.769L0.5 9.5 12 1l11.5 8.5-4.742 4.269C17.548 11.249 14.978 9.5 12 9.5c-2.977 0-5.548 1.748-6.758 4.269zM12 10a7 7 0 1 0 0 14 7 7 0 0 0 0-14z\"\/>\n    <\/svg>\n  <\/a>\n  \n<\/div>\n\n\n\n<p class=\"wp-block-paragraph\">It is a profound honor to share this reflection. As I look back at the <strong>27th Annual Scientific Meeting of the Cambodian Society of Surgery<\/strong>, where I represented the Urology Department of Royal Phnom Penh Hospital on <strong>November 25, 2022<\/strong>, I am struck by a sense of deep professional gratitude. It was my third official presentation at that meeting \u2014 a grounding reminder of why we do what we do: <strong>the patient<\/strong>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Today, I want to move beyond the cold data of clinical trials and narrate a real-world journey \u2014 a story of a patient whose case perfectly illustrates the challenges of managing <strong>uric acid kidney stones<\/strong>. If you have ever been told you have uric acid stones, or you simply want to understand why some kidney stones come back so aggressively, this article is for you.<\/p>\n\n\n\n<figure class=\"wp-block-image aligncenter size-full\"><img data-recalc-dims=\"1\" decoding=\"async\" width=\"800\" height=\"600\" data-attachment-id=\"10250\" data-permalink=\"https:\/\/drsoaraweeurology.com\/ru\/uric-acid-kidney-stones-6-things-you-should-know\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/Uric-Acid-Kidney-Stones-6-Things-You-Should-Know.jpg?fit=800%2C600&amp;ssl=1\" data-orig-size=\"800,600\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;1&quot;}\" data-image-title=\"Uric Acid Kidney Stones \u2014 6 Things You Should Know | Visual Summary by Dr. Soarawee\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;Uric Acid Kidney Stones \u2014 6 things you should know&lt;\/p&gt;\n\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/Uric-Acid-Kidney-Stones-6-Things-You-Should-Know.jpg?fit=800%2C600&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/Uric-Acid-Kidney-Stones-6-Things-You-Should-Know.jpg?resize=800%2C600&#038;ssl=1\" alt=\"Visual summary infographic by Dr. Soarawee Weerasopone \u2014 6 things you should know about uric acid kidney stones, including pH-dependent crystallization, dissolution therapy with alkalinization, and the importance of stone analysis for long-term prevention\" class=\"wp-image-10250\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/Uric-Acid-Kidney-Stones-6-Things-You-Should-Know.jpg?w=800&amp;ssl=1 800w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/Uric-Acid-Kidney-Stones-6-Things-You-Should-Know.jpg?resize=300%2C225&amp;ssl=1 300w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/Uric-Acid-Kidney-Stones-6-Things-You-Should-Know.jpg?resize=768%2C576&amp;ssl=1 768w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/Uric-Acid-Kidney-Stones-6-Things-You-Should-Know.jpg?resize=16%2C12&amp;ssl=1 16w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption class=\"wp-element-caption\">Uric Acid Kidney Stones \u2014 6 things you should know<\/figcaption><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\">What Makes Uric Acid Stones Different?<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Most people have heard of kidney stones, but uric acid stones behave in a distinctly different way from the more common calcium oxalate type. Three things set them apart:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>They are pH-dependent.<\/strong> Uric acid crystals form when the urine becomes too acidic \u2014 typically a urine pH below 5.8.<\/li>\n\n\n\n<li><strong>They can be dissolved.<\/strong> Unlike calcium-based stones, uric acid stones can sometimes be dissolved with medication \u2014 a process called <em>chemolitholysis<\/em> or alkalinization therapy. This is unique among kidney stone types.<\/li>\n\n\n\n<li><strong>They have a very high recurrence risk.<\/strong> Without ongoing management, uric acid stones come back \u2014 often quickly and aggressively.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">For the patient-friendly fundamentals of how kidney stones form and how to prevent them through diet, you may find it useful to read my earlier guide on <a href=\"https:\/\/drsoaraweeurology.com\/2026\/05\/13\/kidney-stone-prevention-management-guide\/\">kidney stone prevention and management<\/a>.<\/p>\n\n\n\n<figure class=\"wp-block-image aligncenter size-full\"><img data-recalc-dims=\"1\" decoding=\"async\" width=\"800\" height=\"600\" data-attachment-id=\"5626\" data-permalink=\"https:\/\/drsoaraweeurology.com\/ru\/urological-surgery-continue-study\/27th-cambodia-speaker\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/01\/27th-Cambodia-Speaker.jpg?fit=1200%2C900&amp;ssl=1\" data-orig-size=\"1200,900\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;1.5&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;iPhone 13 Pro Max&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;1669394521&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;5.6999998092633&quot;,&quot;iso&quot;:&quot;250&quot;,&quot;shutter_speed&quot;:&quot;0.02&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;1&quot;}\" data-image-title=\"27th Annual Scientific Meeting of the Cambodian Society of Surgery\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;Dr. Soarawee during being a speaker at 27th Annual Scientific Meeting of the Cambodian Society of Surgery&lt;\/p&gt;\n\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/01\/27th-Cambodia-Speaker.jpg?fit=800%2C600&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/01\/27th-Cambodia-Speaker.jpg?resize=800%2C600&#038;ssl=1\" alt=\"Dr. Soarawee during being a speaker at 27th Annual Scientific Meeting of the Cambodian Society of Surgery\" class=\"wp-image-5626\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/01\/27th-Cambodia-Speaker.jpg?w=1200&amp;ssl=1 1200w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/01\/27th-Cambodia-Speaker.jpg?resize=300%2C225&amp;ssl=1 300w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/01\/27th-Cambodia-Speaker.jpg?resize=1024%2C768&amp;ssl=1 1024w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/01\/27th-Cambodia-Speaker.jpg?resize=768%2C576&amp;ssl=1 768w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/01\/27th-Cambodia-Speaker.jpg?resize=16%2C12&amp;ssl=1 16w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/01\/27th-Cambodia-Speaker.jpg?resize=800%2C600&amp;ssl=1 800w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/01\/27th-Cambodia-Speaker.jpg?resize=400%2C300&amp;ssl=1 400w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/01\/27th-Cambodia-Speaker.jpg?resize=200%2C150&amp;ssl=1 200w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/01\/27th-Cambodia-Speaker.jpg?resize=750%2C563&amp;ssl=1 750w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption class=\"wp-element-caption\">Dr. Soarawee during being a speaker at 27th Annual Scientific Meeting of the Cambodian Society of Surgery<\/figcaption><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\">A Patient Story \u2014 From Agony to Recovery<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The story I am about to share spans more than two years and illustrates almost every challenge that uric acid stones can pose. Names and identifying details have been generalised, but the medical journey is faithful to what actually happened.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">The Sudden Storm \u2014 October 2020<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Our journey begins with a 50-year-old international patient. He was healthy, with no underlying chronic diseases \u2014 the kind of patient who rarely thinks about hospitals until he has no choice. That choice was made for him in October 2020 when he was struck by severe, agonising right flank pain.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">His CT scan revealed the true extent of the \u201cstorm\u201d inside him: a 6.5 mm stone lodged at the right ureterovesical junction (UVJ), causing obstructive uropathy (kidney swelling), and two more stones (14 mm and 4 mm) resting in the lower part of his right kidney. His urine pH was 7.0 \u2014 a clue we would only fully appreciate later.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The immediate priority was to relieve the obstruction and the pain. We performed an <strong>endoscopic Holmium laser lithotripsy<\/strong> to break up the obstructing stone and placed a <strong>Double-J (DJ) ureteric stent<\/strong> to ensure his kidney could drain. We then performed two sessions of <a href=\"https:\/\/drsoaraweeurology.com\/2026\/05\/06\/evolution-of-stone-treatment-eswl\/\">extracorporeal shock wave lithotripsy (ESWL)<\/a> to address the larger stones remaining in the kidney.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">When Healing Goes Wrong \u2014 December 2020<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Six weeks later, the patient returned to have the DJ stent removed \u2014 normally a routine procedure. Or so we thought. When we attempted a flexible cystoscopy, we failed. The reason was a urologist\u2019s nightmare: <strong>severe DJ stent encrustation<\/strong>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">In just six short weeks, the patient\u2019s body had coated the stent in stone material. We had to return to the operating room to carefully remove the encrusted stent. Crucially, we saved those stone fragments and sent them for analysis. <strong>That single decision changed everything.<\/strong><\/p>\n\n\n\n<h3 class=\"wp-block-heading\">The Diagnosis and First \u201cFalse\u201d Peace \u2014 January\u2013February 2021<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">By January 2021, the stone analysis came back: <strong>uric acid stones<\/strong>. This was the \u201cEureka\u201d moment. We started him on alkalinisation therapy with potassium citrate (Uralyt-U) granules using a structured daily regimen. By February 2021, things looked perfect: his urine pH was 7.0, and an ultrasound showed only tiny residual fragments. The patient felt fine \u2014 and that, unfortunately, was the trap.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">The Relapse \u2014 The One-Year Gap (March 2022)<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Believing he was cured, the patient stopped his medication and stopped coming to follow-up appointments. He was lost to our care for a full year. In March 2022, he returned to our clinic in distress, with blood in his urine. A new CT scan was startling:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>A massive <strong>4 cm right staghorn stone<\/strong> had formed.<\/li>\n\n\n\n<li>Multiple smaller stones up to 6 mm filled the right kidney.<\/li>\n\n\n\n<li>The left kidney, previously clear, now contained stones up to 10 mm.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">He was frustrated and confused: \u201cWhy so fast?\u201d he asked. The answer is exactly what makes uric acid stones so dangerous. When urine becomes acidic again, uric acid crystallises rapidly. Months without alkalinisation can undo years of progress.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">The Intensive Battle \u2014 April\u2013June 2022<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">We restarted alkalinisation therapy immediately. One month later, however, nothing had changed \u2014 in fact, a new stone had appeared in the left kidney. We dug deeper into the laboratory data:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Urine pH was 5.0<\/strong> \u2014 what we call \u201curic acid arrest\u201d: the urine was still far too acidic for stones to dissolve.<\/li>\n\n\n\n<li><strong>Serum uric acid was 8.7<\/strong> \u2014 well above the normal range.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">We shifted to an intensive multi-pronged strategy: increased citrate dosing (Pocitrin), added Uralyt-U with daily self-monitoring of urine pH, added <strong>allopurinol<\/strong> to reduce uric acid production at the source, and set a strict target urine pH of <strong>6.5\u20137.2<\/strong>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">By June 2022, we hit another snag in the opposite direction. His urine pH had jumped to 8.0, and his creatinine (a marker of kidney function) had risen to 1.31. <strong>Too much alkalinity can be just as dangerous as too much acidity<\/strong>, sometimes promoting different stone types and stressing the kidneys. We pivoted again \u2014 stopping the citrate combination and switching to oral sodium bicarbonate at a lower, more controlled dose.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Success Through Patience \u2014 November 2022<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Finally, in November 2022, we achieved the goal. The patient\u2019s CT scan showed dramatic improvement, his urine pH had stabilised at 7.0, and his kidney function had recovered. The journey from agony to <strong>chemolitholysis<\/strong> \u2014 dissolving stones with medicine rather than removing them surgically \u2014 was finally working. He was extremely happy. So were we.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">The Science of Uric Acid Stones<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The European Association of Urology (EAU) 2022 Guidelines on Urolithiasis lay out the core facts every uric acid stone patient should understand:<\/p>\n\n\n\n<table style=\"width:100%; border-collapse: collapse; margin: 1.5rem 0; font-family: inherit;\">\n  <thead>\n    <tr style=\"background-color: #1a3a6b; color: #ffffff;\">\n      <th style=\"padding: 12px; text-align: left; border: 1px solid #1a3a6b;\">Key Fact<\/th>\n      <th style=\"padding: 12px; text-align: left; border: 1px solid #1a3a6b;\">Clinical Significance<\/th>\n    <\/tr>\n  <\/thead>\n  <tbody>\n    <tr style=\"background-color: #f5f7fa;\">\n      <td style=\"padding: 12px; border: 1px solid #d1d5db; vertical-align: top;\"><strong>Prevalence<\/strong><\/td>\n      <td style=\"padding: 12px; border: 1px solid #d1d5db; vertical-align: top;\">Uric acid stones make up about 10% of all kidney stones \u2014 less common than calcium oxalate, but more aggressive when they appear.<\/td>\n    <\/tr>\n    <tr>\n      <td style=\"padding: 12px; border: 1px solid #d1d5db; vertical-align: top;\"><strong>Recurrence<\/strong><\/td>\n      <td style=\"padding: 12px; border: 1px solid #d1d5db; vertical-align: top;\">Very high risk of returning if not actively managed long-term, even after a stone is dissolved or removed.<\/td>\n    <\/tr>\n    <tr style=\"background-color: #f5f7fa;\">\n      <td style=\"padding: 12px; border: 1px solid #d1d5db; vertical-align: top;\"><strong>The pH Factor<\/strong><\/td>\n      <td style=\"padding: 12px; border: 1px solid #d1d5db; vertical-align: top;\">A urine pH below 5.8 is the primary driver of uric acid crystallisation. Keeping pH in the 6.5\u20137.2 target range is essential for prevention.<\/td>\n    <\/tr>\n    <tr>\n      <td style=\"padding: 12px; border: 1px solid #d1d5db; vertical-align: top;\"><strong>Stone Analysis<\/strong><\/td>\n      <td style=\"padding: 12px; border: 1px solid #d1d5db; vertical-align: top;\">Strongly recommended for first-time stone formers and anyone with early recurrence \u2014 it is the only way to know exactly what type of stone you make.<\/td>\n    <\/tr>\n  <\/tbody>\n<\/table>\n\n\n\n<h2 class=\"wp-block-heading\">Why Stone Analysis Is Non-Negotiable<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The single most important moment in this patient\u2019s entire journey was the decision to send those tiny stent-encrustation fragments for analysis. Without that result, we would have continued treating him as an \u201cordinary\u201d stone former, missing the one therapy that could actually dissolve his stones.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">If you have ever passed a kidney stone, ask your urologist whether it was sent for stone composition analysis. If it wasn\u2019t, ask what the next steps are when (not if) the next stone appears. <strong>Stone analysis is the foundation of all long-term prevention.<\/strong><\/p>\n\n\n\n<h2 class=\"wp-block-heading\">What You Should Do If You&#8217;ve Had a Uric Acid Stone<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">If your stone has been confirmed as uric acid, here are the principles I share with every patient I meet at Bangkok Hospital:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Do not stop your medication when you feel better.<\/strong> The patient in this story relapsed for exactly this reason. Uric acid stones return aggressively when alkalinisation is interrupted.<\/li>\n\n\n\n<li><strong>Self-monitor your urine pH<\/strong> with a simple pH test strip. Aim for a stable pH in the 6.5\u20137.2 range \u2014 not too acidic, not too alkaline.<\/li>\n\n\n\n<li><strong>Hydrate aggressively.<\/strong> More than 2.5 litres of fluid per day, as outlined in the general <a href=\"https:\/\/drsoaraweeurology.com\/2026\/05\/13\/kidney-stone-prevention-management-guide\/\">kidney stone prevention guidelines<\/a>.<\/li>\n\n\n\n<li><strong>Address the underlying drivers.<\/strong> High-purine diets (organ meats, anchovies, shellfish), heavy alcohol intake, obesity, and metabolic syndrome all push urine pH downward. Modifying these matters as much as the medication.<\/li>\n\n\n\n<li><strong>Stay in regular follow-up.<\/strong> Imaging and urine pH checks every 6\u201312 months catch problems before they become surgical emergencies.<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">Take-Home Messages<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Stone analysis is non-negotiable.<\/strong> It is the cornerstone of long-term management and prevention. It allows us to treat the cause, not just the symptom.<\/li>\n\n\n\n<li><strong>The doctor\u2013patient relationship is the cure.<\/strong> Successful management of uric acid stones depends entirely on trust. The patient must be a partner in their own care, especially in self-monitoring urine pH.<\/li>\n\n\n\n<li><strong>Education is everything.<\/strong> Clear communication is what turns a frightening diagnosis into a manageable, long-term plan.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">While surgery can remove a stone, only dedicated, ongoing medical management can keep a patient stone-free. If you have a history of uric acid stones, recurrent kidney stones, or unclear stone composition, Dr. Soarawee Weerasopone offers specialist consultations at Bangkok Hospital Headquarters. <a href=\"https:\/\/www.bangkokhospital.com\/en\/bangkok\/doctor\/dr-soarawee-weerasopone-2\" target=\"_blank\" rel=\"noreferrer noopener\">Book a Consultation<\/a>.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Frequently Asked Questions About Uric Acid Kidney Stones<\/h2>\n\n\n\n<h3 class=\"wp-block-heading\">Can uric acid kidney stones really be dissolved without surgery?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Yes \u2014 uric acid stones are unique among kidney stones because they can be dissolved through alkalinisation therapy, which raises urine pH into the 6.5\u20137.2 range. This process is called chemolitholysis. It requires close medical supervision, urine pH monitoring, and consistent medication adherence over months. Calcium-based stones cannot be dissolved this way.<\/p>\n\n\n<p><!-- quoteblock omitted, ends here --><\/p>\n\n\n<h3 class=\"wp-block-heading\">What causes uric acid stones to form?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Uric acid stones form when the urine becomes too acidic, typically with a urine pH below 5.8. Common contributors include high-purine diets (red meat, organ meats, shellfish), heavy alcohol use, obesity, metabolic syndrome, gout, and chronic dehydration. Genetic factors and certain medications can also play a role.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Why do uric acid stones come back so quickly?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Uric acid stones have an exceptionally high recurrence rate because the underlying problem \u2014 acidic urine \u2014 returns the moment alkalinisation therapy is stopped. Months without medication can be enough for new stones to form, including large staghorn stones that fill the entire kidney. Continuous, long-term management is essential.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">What urine pH should I aim for if I have uric acid stones?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">The target urine pH is 6.5\u20137.2. Below 5.8 promotes uric acid crystallisation; above 7.5 can promote different problems, including calcium phosphate stones and reduced kidney function. Self-monitoring with simple pH test strips, under your urologist\u2019s guidance, helps keep you in the safe zone.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Why is stone analysis so important?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Stone analysis is the only way to know exactly what type of kidney stone you form, which directly determines treatment. A uric acid stone can be dissolved with medication; a calcium oxalate stone cannot. Without stone analysis, urologists are guessing \u2014 and patients miss the chance for the most effective, least invasive long-term care.<\/p>\n\n\n\n<script type=\"application\/ld+json\">\n{\n  \"@context\": \"https:\/\/schema.org\",\n  \"@type\": \"FAQPage\",\n  \"mainEntity\": [\n    {\n      \"@type\": \"Question\",\n      \"name\": \"Can uric acid kidney stones really be dissolved without surgery?\",\n      \"acceptedAnswer\": {\n        \"@type\": \"Answer\",\n        \"text\": \"Yes - uric acid stones are unique among kidney stones because they can be dissolved through alkalinisation therapy, which raises urine pH into the 6.5-7.2 range. This process is called chemolitholysis. It requires close medical supervision, urine pH monitoring, and consistent medication adherence over months. Calcium-based stones cannot be dissolved this way.\"\n      }\n    },\n    {\n      \"@type\": \"Question\",\n      \"name\": \"What causes uric acid stones to form?\",\n      \"acceptedAnswer\": {\n        \"@type\": \"Answer\",\n        \"text\": \"Uric acid stones form when the urine becomes too acidic, typically with a urine pH below 5.8. Common contributors include high-purine diets (red meat, organ meats, shellfish), heavy alcohol use, obesity, metabolic syndrome, gout, and chronic dehydration. Genetic factors and certain medications can also play a role.\"\n      }\n    },\n    {\n      \"@type\": \"Question\",\n      \"name\": \"Why do uric acid stones come back so quickly?\",\n      \"acceptedAnswer\": {\n        \"@type\": \"Answer\",\n        \"text\": \"Uric acid stones have an exceptionally high recurrence rate because the underlying problem - acidic urine - returns the moment alkalinisation therapy is stopped. Months without medication can be enough for new stones to form, including large staghorn stones that fill the entire kidney. Continuous, long-term management is essential.\"\n      }\n    },\n    {\n      \"@type\": \"Question\",\n      \"name\": \"What urine pH should I aim for if I have uric acid stones?\",\n      \"acceptedAnswer\": {\n        \"@type\": \"Answer\",\n        \"text\": \"The target urine pH is 6.5-7.2. Below 5.8 promotes uric acid crystallisation; above 7.5 can promote different problems, including calcium phosphate stones and reduced kidney function. Self-monitoring with simple pH test strips, under your urologist's guidance, helps keep you in the safe zone.\"\n      }\n    },\n    {\n      \"@type\": \"Question\",\n      \"name\": \"Why is stone analysis so important?\",\n      \"acceptedAnswer\": {\n        \"@type\": \"Answer\",\n        \"text\": \"Stone analysis is the only way to know exactly what type of kidney stone you form, which directly determines treatment. A uric acid stone can be dissolved with medication; a calcium oxalate stone cannot. Without stone analysis, urologists are guessing - and patients miss the chance for the most effective, least invasive long-term care.\"\n      }\n    }\n  ]\n}\n<\/script>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Disclaimer:<\/strong> This content is medically written and reviewed by Dr. Soarawee Weerasopone, a board-certified urologist at Bangkok Hospital Headquarters. It is intended for educational purposes only and does not constitute medical advice. Patient details in this article have been generalised to protect privacy. Medication doses and treatment regimens described are illustrative; treatment must always be individualised by a qualified urologist. Always consult a qualified healthcare professional before starting any medical treatment.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Soarawee Weerasopone, Urologist Bangkok hospital Headquarter, Bangkok Samitivej Sriracha hospital, Chonburi It is a profound honor to share this reflection. As I look back at the 27th Annual Scientific Meeting of the Cambodian Society of Surgery, where I represented the Urology Department of Royal Phnom Penh Hospital on November 25, 2022, I am struck by [&hellip;]<\/p>\n","protected":false},"author":185281453,"featured_media":10240,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"advanced_seo_description":"Dr. Soarawee Weerasopone, urologist at Bangkok Hospital, explains uric acid kidney stones \u2014 why they form, how alkalinization therapy can dissolve them, and how to prevent recurrence.","jetpack_seo_html_title":"Uric Acid Kidney Stones: Diagnosis, Dissolution & Prevention | Dr. Soarawee","jetpack_seo_noindex":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_feature_clip_id":0,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"{title}\n\n{excerpt}\n\n{url}","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2},"_wpas_customize_per_network":false,"jetpack_post_was_ever_published":false},"categories":[1],"tags":[],"class_list":["post-10230","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-kidney-stone"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/The-Silent-Architect-of-Stones.jpg?fit=1200%2C630&ssl=1","jetpack_likes_enabled":false,"jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/pgZdrK-2F0","_links":{"self":[{"href":"https:\/\/drsoaraweeurology.com\/ru\/wp-json\/wp\/v2\/posts\/10230","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/drsoaraweeurology.com\/ru\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/drsoaraweeurology.com\/ru\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/drsoaraweeurology.com\/ru\/wp-json\/wp\/v2\/users\/185281453"}],"replies":[{"embeddable":true,"href":"https:\/\/drsoaraweeurology.com\/ru\/wp-json\/wp\/v2\/comments?post=10230"}],"version-history":[{"count":4,"href":"https:\/\/drsoaraweeurology.com\/ru\/wp-json\/wp\/v2\/posts\/10230\/revisions"}],"predecessor-version":[{"id":10280,"href":"https:\/\/drsoaraweeurology.com\/ru\/wp-json\/wp\/v2\/posts\/10230\/revisions\/10280"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/drsoaraweeurology.com\/ru\/wp-json\/wp\/v2\/media\/10240"}],"wp:attachment":[{"href":"https:\/\/drsoaraweeurology.com\/ru\/wp-json\/wp\/v2\/media?parent=10230"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/drsoaraweeurology.com\/ru\/wp-json\/wp\/v2\/categories?post=10230"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/drsoaraweeurology.com\/ru\/wp-json\/wp\/v2\/tags?post=10230"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}