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. Author manuscript; available in PMC: 2021 Nov 1.
Published in final edited form as: Semin Nephrol. 2020 Nov;40(6):564–573. doi: 10.1016/j.semnephrol.2020.12.003

Figure 5: Model for pathogenesis of ammonium acid urate stones.

Figure 5:

Contributors to high urine ammonium include physiologic response to acid load and intraluminal generation of ammonium from urea. One of the byproduct of ureolysis is HCO3/CO32−, which also alkalinizes the urine. Increased endogenous or exogenous purine load and metabolism leads to increased uric acid generation, and the high urine pH (UpH) ensures that urate form is preferred.