Allopurinol Treatment of Renal Calcium Stone Disease

Abstract

Thirty-one calcium stone patients were treated with 300 mg allopurinol daily during a mean follow-up period of 2 years. They were also given advice on diet and fluid intake. The effects on the recurrence rate of stones were compared with the effects on the recurrence rate in 43 calcium stone patients who were given similar advice on diet and fluid intake but were not treated with allopurinol. In both groups there was a reduction in the recurrence rate but no difference between patients treated with allopurinol and the control group. Some patients with only hyperuricosuria prior to treatment seemed to benefit from allopurinol treatment, whereas those with hypercalciuria continued to form stones with the same frequency. Allopurinol treatment in calcium stone disease appears less effective than treatment with thiazides, magnesium hydroxide or orthophosphate.

Possibilities for preventing recurrent calcium stone formation: principles for the metabolic evaluation of patients with calcium stone disease

“…In two open studies Coe and Raisen showed a significant reduction in the risk of calcium oxalate stone formation in hyperuricosuric patients treated with allopurinol [46,47], but these results have not been confirmed in other studies [48–50].…”

Rational Prevention of Calcium Urolithiasis

“…Rose et al [34] changed urate concentrations of urine samples without any effect on oxalate crystal for mation. Uric acid excretion can be reduced to almost 50% by a daily intake of 300 mg allopurinol [13,37].…”

“…Controverse data exist in the literature concernig the frequency of hyperurico suria in calcium stone formers [11,13]. A critical study of Fellstrom et al [13] does not reveal a different rate of hyperuricosuria between healthy persons and calcium stone formers.…”

Potential Pharmacologic Treatments for Cystinuria and for Calcium Stones Associated with Hyperuricosuria

“…Review of this literature demonstrates a paucity of evidence. In one frequently cited article, a nonrandomized trial, 31 patients were treated with allopurinol, and 43 patients served as untreated controls for recurrent calcium stones (9). Overall, patients who were treated with allopurinol had a recurrence rate of 49% (15 of 31), whereas the control patients, who were not treated with allopurinol, had a recurrence rate of 40% (17 of 43).…”