Q: I am a 25 years old man having kidney stones for the last 2-3 years. These are due to uric acid formation. Currently there are 2 stones of size 9 mm each in both the kidneys. The doctor has asked for laser surgery. From last one week, I have pain in the back at both the sides. I was taking Zyloric 100 mg and now the doctor has asked to triple the dose. I got my urine tested and the report stated the presence of blood cells in urine, uric acid, albumin (+++) and RBC-innumerable presence of serum calcium is 7.79. Is there any risk to my kidneys?

A:Review of your history is suggestive of recurrent uric acid stone formation resulting in symptoms of pain due to stone obstruction of the urinary tract. Firstly, to deal with acute symptom of pain, one would need to be adequately managed with pain medications while also needing a surgical intervention for an obstructing stone as in your case. Most often, stones of size greater than 5 mm do not pass spontaneously in spite of being on medication as listed above. It requires surgical intervention especially to prevent any acute injury to the concerned kidney resulting from the stone. Next, increased intake of fluid (approximately >1.6 litres/day) and daily intake of alkali medications like potassium citrate or potassium bicarbonate (intended to increase the local pH of the urine thereby preventing and at times dissolving a formed uric acid stone) would help in preventing recurrent uric acid stone formation. Long-standing intake of Zyloric (allopurinol) helps to reduce the production and hence the excretion of uric acid into the urine. Lastly, reduction of dietary purine intake may help reduce the generation of uric acid in the blood and the urine. For this you may need to see a dietician to review the diet.