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Laxative abuse as a cause for ammonium urate renal calculi.

Publication ,  Journal Article
Dick, WH; Lingeman, JE; Preminger, GM; Smith, LH; Wilson, DM; Shirrell, WL
Published in: J Urol
February 1990

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.

Duke Scholars

Published In

J Urol

DOI

ISSN

0022-5347

Publication Date

February 1990

Volume

143

Issue

2

Start / End Page

244 / 247

Location

United States

Related Subject Headings

  • Water-Electrolyte Imbalance
  • Urology & Nephrology
  • Uric Acid
  • Substance-Related Disorders
  • Self Medication
  • Phenolphthaleins
  • Middle Aged
  • Kidney Calculi
  • Humans
  • Female
 

Citation

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Dick, W. H., Lingeman, J. E., Preminger, G. M., Smith, L. H., Wilson, D. M., & Shirrell, W. L. (1990). Laxative abuse as a cause for ammonium urate renal calculi. J Urol, 143(2), 244–247. https://doi.org/10.1016/s0022-5347(17)39923-8
Dick, W. H., J. E. Lingeman, G. M. Preminger, L. H. Smith, D. M. Wilson, and W. L. Shirrell. “Laxative abuse as a cause for ammonium urate renal calculi.J Urol 143, no. 2 (February 1990): 244–47. https://doi.org/10.1016/s0022-5347(17)39923-8.
Dick WH, Lingeman JE, Preminger GM, Smith LH, Wilson DM, Shirrell WL. Laxative abuse as a cause for ammonium urate renal calculi. J Urol. 1990 Feb;143(2):244–7.
Dick, W. H., et al. “Laxative abuse as a cause for ammonium urate renal calculi.J Urol, vol. 143, no. 2, Feb. 1990, pp. 244–47. Pubmed, doi:10.1016/s0022-5347(17)39923-8.
Dick WH, Lingeman JE, Preminger GM, Smith LH, Wilson DM, Shirrell WL. Laxative abuse as a cause for ammonium urate renal calculi. J Urol. 1990 Feb;143(2):244–247.
Journal cover image

Published In

J Urol

DOI

ISSN

0022-5347

Publication Date

February 1990

Volume

143

Issue

2

Start / End Page

244 / 247

Location

United States

Related Subject Headings

  • Water-Electrolyte Imbalance
  • Urology & Nephrology
  • Uric Acid
  • Substance-Related Disorders
  • Self Medication
  • Phenolphthaleins
  • Middle Aged
  • Kidney Calculi
  • Humans
  • Female