What is the first step in treating uric acid kidney stones?

Encouraging hydration is considered the first step in treating uric acid kidney stones because it plays a crucial role in preventing stone formation and aiding in the passage of stones. Increased fluid intake dilutes the urine, which helps to reduce the concentration of uric acid. When the urine is less concentrated, the likelihood of uric acid crystallizing and forming stones decreases. Additionally, staying well-hydrated can help flush out smaller stones and prevent future stone formation.

Alkalinizing the urine is also an important treatment for uric acid stones, as it can help to dissolve existing stones and prevent new ones from forming, but it is not typically the very first step. Prescribing allopurinol can be effective for managing uric acid levels, particularly in patients with conditions that increase uric acid production, yet it is generally initiated after hydration has been addressed. Reducing protein intake may be beneficial for some patients, as it can lower uric acid production from dietary sources, but again, establishing hydration is prioritized to manage current stone disease effectively.