THE METABOLIC DEFECT RESPONSIBLE FOR URIC ACID STONE FORMATION*

Abstract

Uric acid renal stones may occur in hyper-uricemic, hyperuriciuric gouty patients but more often occur in elderly Italian or Jewish patients with normal serum and urinary uric acid levels. Precipitation of uric acid in such patients is probably due to the constant marked acidity of their urine. In four such patients the marked acidity was associated with a low ammonium excretion; two patients showed increases in ammonium excretion after acid loading which were less than those observed in three normal young subjects.