A client who has gout is most likely to form which type of renal calculi?

Gout is a metabolic disorder characterized by hyperuricemia, which is an elevated level of uric acid in the blood. The kidneys excrete this excess uric acid. When urine becomes supersaturated with uric acid, particularly in an acidic environment, it can crystallize and form solid stones. Therefore, clients with a history of gout are at a significantly higher risk of developing uric acid renal calculi compared to other types of kidney stones.

A. Struvite stones: These are infection stones, formed in the presence of urease-producing bacteria, and are not directly related to the metabolic abnormalities of gout.

B. Staghorn calculi: This term describes the large, branching shape of a kidney stone that fills the renal pelvis and calyces; it is not a chemical type.

D. Calcium stones: While being the most common type of kidney stone, they are primarily associated with hypercalciuria (high calcium in urine), not the hyperuricemia seen in gout.

1. Hinkle, J. L., & Cheever, K. H. (2018). Brunner & Suddarth's Textbook of Medical-Surgical Nursing (14th ed.). Wolters Kluwer. In Chapter 55, Management of Patients With Urinary Disorders, the section on Urolithiasis and Nephrolithiasis states, "Uric acid stones account for 5% to 10% of all stones and may be seen in patients with gout or myeloproliferative disorders." (p. 1608).

2. Torricelli, F. C. M., De, S. K., & Monga, M. (2014). Uric acid nephrolithiasis. Indian Journal of Urology, 30(1), 65–70. In the "Introduction" section, paragraph 1, the article states, "Risk factors for UA stone formation include conditions that cause hyperuricosuria (e.g., gout, myeloproliferative disorders, and uricosuric drugs), and conditions that cause low urinary pH." https://doi.org/10.4103/0970-1591.124206

3. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). (2017). Kidney Stones. U.S. Department of Health and Human Services, National Institutes of Health. In the section "What are the types of kidney stones?", under the subheading "Uric acid stones," it is noted that "Uric acid stones may form in people who... have gout." (NIH Publication No. 17–4606).