Abstract
Uric acid is a metabolite of animal protein. Excess urinary uric acid can lead to calcium oxalate and uric acid stone formation. Elevated urinary uric acid, low urine pH, and uric acid stone formation are associated with truncal obesity, metabolic syndrome, and diabetes. The key urinary risk factors for uric acid stones are low urine pH, high urinary uric acid levels, and insufficient urine volume. This chapter reviews the physiology and pathophysiology of uric acid metabolism as it relates to uric acid stone formation and reviews the evidence and rationale for specific dietary approaches to stone prevention.