Editing Stones: Epidemiology and Pathogenesis (section)

=== Ammonium acid urate stones ===
* Infrequently seen in industrialized nations
* '''Associated with laxative abuse, recurrent UTI, recurrent uric acid stone formation, inflammatory bowel disease, and children with low-protein, low-phosphate diet resulting in primary bladder calculus'''
** '''Ammonium excretion is increased with starvation, dehydration, or consumption of acid-forming foods or toxins§'''
** Subjects who abuse laxatives are chronically dehydrated, resulting in intracellular acidosis. In addition, urinary sodium is low from sodium loss as a result of the laxatives. In this environment, urate preferentially complexes with the abundant ammonium rather than sodium and produces ammonium acid urate stones.