Drug treatment for kidney and ureteral stones

Various treatments fall under the umbrella term of medical stone treatment. Almost every patient asks whether it is possible to dissolve kidney stones with medication. Although this method would naturally be highly desirable, unfortunately “dissolving” stones is only possible for a very small proportion. Stones that can be dissolved are uric acid stones, using a treatment known as chemolitholysis.

If a stone is already in the ureter, medication can help the stone pass naturally. This option is available for small stones, provided that the pain is tolerable, and laboratory and urine parameters are within certain limits. This treatment is known as conservative stone treatment.

For patients who repeatedly form stones, taking medication can be useful depending on the stone composition. Administration of medicine is always combined with other measures, such as increasing daily fluid intake or a change in lifestyle habits. This type of prevention is known as stone metaphylaxis and can prolong the intervals between the recurrence of urinary stones or prevent the formation of new stones altogether. Close coordination with the urologist is necessary for this form of treatment.

What does chemolitholysis mean?

Chemolitholysis refers to the medicinal “dissolving” of urinary stones. This treatment is only effective for uric acid stones. The medicine increases the pH value in the patient’s urine, a process known as urinary alkalisation. If urine is less acidic, uric acid stones are able to dissolve. The pH value can be determined by means of test strips. Depending on the value, the medication dose is adjusted until the pH value is between 7.0 and 7.2. This value must be maintained for a few weeks.

To prevent the formation of new uric acid stones, urinary alkalising medication can also be taken on a permanent basis. The target pH value should stay between 6.2 and 6.8. Lowering uric avid levels in the blood can also be useful. Aside from deacidification, weight loss and reduction of purine-rich foods can have a positive effect. If this is not enough, medication can be used to also lower uric acid levels in the blood. This is done as part of the treatment of gout disease, which is also the result of elevated uric acid levels.