Laxative abuse as a cause for ammonium urate renal calculi.

Journal Article (Journal Article)

Nine women with laxative abuse and predominantly ammonium urate renal calculi underwent metabolic studies to identify common chemical abnormalities and determine pathophysiology. The 24-hour urine studies demonstrated marked decreases in volume (902 cm.3), sodium (28 mEq.), citrate (116 mg.) and potassium (21 mEq.). A significant elevation in ammonium urate supersaturation was found compared to control subjects when studied by the computer model EQUIL 2. Of the patients 7 had 1 or more urine specimens positive for phenolphthalein. Gastrointestinal loss of fluid and electrolytes allowed for chronic extracellular volume depletion. Intracellular acidosis was present as judged by low urinary citrate and potassium. The fact that the ion product for ammonium urate is increased significantly compared to controls reflects the stated pathophysiological changes. Laxative abuse should be suspected whenever a woman has an ammonium urate renal calculus in sterile urine.

Full Text

Duke Authors

Cited Authors

  • Dick, WH; Lingeman, JE; Preminger, GM; Smith, LH; Wilson, DM; Shirrell, WL

Published Date

  • February 1990

Published In

Volume / Issue

  • 143 / 2

Start / End Page

  • 244 - 247

PubMed ID

  • 2299711

International Standard Serial Number (ISSN)

  • 0022-5347

Digital Object Identifier (DOI)

  • 10.1016/s0022-5347(17)39923-8


  • eng

Conference Location

  • United States