By vgreene, 11 July, 2024 If U urate plus hyperuricemia 380 mol L give alkaline citrate 3 10 g day plus allopurinol 100 300 mg day 2nd line tx febuxostat 80 mg day Strong 1
By vgreene, 11 July, 2024 If U urate 4 mmol day without UCa give alkaline citrate 3 10 g day or bicarb 1 5 g tid plus or allopurinol 100 mg day Strong 1
By vgreene, 11 July, 2024 If U oxalate 1 mmol day due to primary genetic hyperoxaluria give pyridoxin 5 mg kg day initial dose up to 10 mg kg day1
By vgreene, 11 July, 2024 If U oxalate 0 5 1 mmol day due to hyperabsorption of oxalate or extreme dietary intake give Ca 1 2 g day beware excess Ca excretion Strong 1 plus Mg 200 400 mg day low evidence Consider alkaline citrates to replace citrate loss and raise urine pH Weak 1
By vgreene, 11 July, 2024 If UCa 8 mmol day give HCTZ 25 50 mg day1 3 Strong or chlorthalidone 25 g day1 or indapamide 2 5 mg day 1 Advise pts on HCTZ to get their skin checked on a regular basis as they have a higher risk of NMSC and some forms of melanoma Caution in pts with hx
By vgreene, 11 July, 2024 If UCa 5 8 mmol day give alkaline citrate 3 10 g day or NaBicarb 1 5 g tid Strong