We report two patients with renal uric acid (UA) stones in whom chemolysis by oral administration of alkaline citrate and allopurinol was unsuccessful. The stone in a 58-year old female did not dissolve because her urinary pH remained low throughout the day after alkaline citrate administration. The stone in a 50-year old man did not dissolve because his urinary pH was 5.5-6.0 after alkaline citrate administration. Alkalization of the urine helps reduce the stone size and the calcification of the stone. Extracorporeal shockwave lithotripsy was performed and the stone composition showed mixed calcium oxalate and calcium phosphate. The indication of oral chemolysis of uric acid stones is discussed.
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