{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T08:57:16Z","timestamp":1790585836905,"version":"4.1.0"},"reference-count":17,"publisher":"PAGEPress Publications","issue":"3","license":[{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arch Ital Urol Androl"],"abstract":"<jats:p>Background: Urine acidification and inhibition of crystallization are strategies that can be employed to prevent recurrent infection stones and calcium phosphate stones.\nMethods: A series of cases demonstrating the beneficial effects of treatment with phytate and L-methionine in preventing recurrent stones associated with urinary tract infections and brushite stones is presented.\nResults: The treatment proved effective in the prevention of stones associated with various clinical conditions. We describe three cases of staghorn infection renal stone, three cases of recurrent renal infection stones, one case with recurrent brushite stones and one case of dystrophic tissue calcification. In this group, ages ranged from 26 to 77 years, and the M\/F ratio was 4:4. In most cases the initial urinary pH was approximately 8-8.2. Stone composition was magnesium ammonium phosphate (struvite) in 4 cases, a mixture of struvite and apatite in other 2 cases, and brushite in 2 cases. Pathogens isolated in the urine cultures of patients with struvite containing stones included Proteus spp. in 3 cases, Escherichia coli in 2 cases, and Klebsiella pneumoniae in one case. A combination of phytate and L-methionine was administered in all cases. Urinary pH was monitored using a portable medical device. In the six cases with infection stones, treatment prevented stone recurrence or regrowth following surgical treatment. Recurrence of infection was also prevented and renal function stabilized or improved. Administration of phytate and L-methionine with frequent urinary pH monitoring was also effective in the case of recurrent brushite stone formation and in the prevention of extensive dystrophic calcifications of the prostatic bed following HoLEP for benign prostatic hyperplasia treatment.\nConclusions: The findings of these case reports demonstrate that urinary acidification can be effectively achieved by oral administration of L-methionine in association with phytate in patients with chronic urinary tract infections who form urinary stones with the goal of preventing stone and infection recurrence and preserving renal function.<\/jats:p>","DOI":"10.4081\/aiua.2026.15985","type":"journal-article","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T08:18:53Z","timestamp":1790583533000},"source":"Crossref","is-referenced-by-count":0,"title":["Phytate and L-methionine for preventing recurrence of infection renal stones"],"prefix":"10.4081","volume":"98","author":[{"given":"Bel\u00e9n","family":"Barba","sequence":"first","affiliation":[{"name":"Hospital Universitario de Jerez de la Frontera, Jerez de la Frontera"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alba","family":"Farr\u00e9","sequence":"additional","affiliation":[{"name":"Hospital Universitario de Girona Dr. Josep Trueta, Girona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emili","family":"Maicas","sequence":"additional","affiliation":[{"name":"Hospital Clinic i Provincial de Barcelona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jes\u00fas","family":"Maqueda","sequence":"additional","affiliation":[{"name":"Hospital Universitario Fundaci\u00f3n Jimenez Diaz, Madrid"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maite","family":"Miqueleiz","sequence":"additional","affiliation":[{"name":"Hospital Universitario de Navarra, Pamplona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmina","family":"Mu\u00f1oz","sequence":"additional","affiliation":[{"name":"Clinica Universidad de Navarra, Madrid"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Palacios","sequence":"additional","affiliation":[{"name":"Hospital Cl\u00ednico Universitario Lozano Blesa, Zaragoza"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c1lvaro","family":"Vadillo","sequence":"additional","affiliation":[{"name":"Hospital Universitario Virgen del Valme, Sevilla"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Pilar","family":"Alcoba","sequence":"additional","affiliation":[{"name":"Hospital Universitario Fundaci\u00f3n Jimenez Diaz, Madrid"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zaloa","family":"Amelibia \u00c1lvaro","sequence":"additional","affiliation":[{"name":"Hospital Universitario de Navarra, Pamplona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gonzalo","family":"Bueno","sequence":"additional","affiliation":[{"name":"Hospital Universitario Fundaci\u00f3n Jimenez Diaz, Madrid"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9s","family":"Calva","sequence":"additional","affiliation":[{"name":"Clinica Universidad de Navarra, Pamplona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nelson","family":"Canales","sequence":"additional","affiliation":[{"name":"Hospital Universitario de Jerez de la Frontera, Jerez de la Frontera"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis","family":"Labairu","sequence":"additional","affiliation":[{"name":"Clinica Universidad de Navarra, Pamplona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Pilar","family":"Luque","sequence":"additional","affiliation":[{"name":"Hospital Clinic i Provincial de Barcelona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asier","family":"Mercad\u00e8","sequence":"additional","affiliation":[{"name":"Hospital Clinic i Provincial de Barcelona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgina Amanda","family":"Payet","sequence":"additional","affiliation":[{"name":"Hospital Clinic i Provincial de Barcelona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"del Carmen Salgado","sequence":"additional","affiliation":[{"name":"Hospital Clinic i Provincial de Barcelona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alba","family":"Sierra","sequence":"additional","affiliation":[{"name":"Hospital Clinic i Provincial de Barcelona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel","family":"Ugidos","sequence":"additional","affiliation":[{"name":"Hospital Universitario de Jerez de la Frontera, Jerez de la Frontera"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen","family":"Arai Valladares","sequence":"additional","affiliation":[{"name":"Hospital Universitario Virgen del Valme, Sevilla"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernat","family":"Isern","sequence":"additional","affiliation":[{"name":"Renal Lithiasis and Pathological Calcification Group (LiRCaP), Universitat de les Illes Balears, Palma;\u00a0Health Research Institute of the Balearic Islands (IdISBa), Palma"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Trinchieri","sequence":"additional","affiliation":[{"name":"CDC Ambrosiana, Milan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2549","published-online":{"date-parts":[[2026,9,28]]},"reference":[{"key":"253650","doi-asserted-by":"crossref","unstructured":"1. Grases F, Costa-Bauz\u00e1 A, Gomila I, et al. Urinary pH and renal lithiasis. Urol Res. 2012; 40:41-6.","DOI":"10.1007\/s00240-011-0389-3"},{"key":"253651","doi-asserted-by":"crossref","unstructured":"2. Bichler KH, Eipper E, Naber K, et al. Urinary infection stones. Int J Antimicrob Agents. 2002; 19:488-98.","DOI":"10.1016\/S0924-8579(02)00088-2"},{"key":"253652","doi-asserted-by":"crossref","unstructured":"3. Klee LW, Brito CG, Lingeman JE. The clinical implications of brushite calculi. J Urol. 1991; 145:715-8.","DOI":"10.1016\/S0022-5347(17)38432-X"},{"key":"253653","doi-asserted-by":"crossref","unstructured":"4. Krambeck AE, Handa SE, Evan AP, Lingeman JE. Profile of the brushite stone former. J Urol. 2010; 184:1367-71.","DOI":"10.1016\/j.juro.2010.05.094"},{"key":"253654","doi-asserted-by":"crossref","unstructured":"5. Siener R, Netzer L, Hesse A. Determinants of brushite stone formation: a case-control study. PLoS One. 2013; 8:e78996.","DOI":"10.1371\/journal.pone.0078996"},{"key":"253655","doi-asserted-by":"crossref","unstructured":"6. Evan AP, Lingeman JE, Coe FL, et al. Crystal-associated nephropathy in patients with brushite nephrolithiasis. Kidney Int. 2005; 67:576-91.","DOI":"10.1111\/j.1523-1755.2005.67114.x"},{"key":"253656","doi-asserted-by":"crossref","unstructured":"7. Tsai P, Maalouf NM. Calcium Phosphate Nephrolithiasis: A Comprehensive Review. Kidney Med. 2026; 8:101301.","DOI":"10.1016\/j.xkme.2026.101301"},{"key":"253657","unstructured":"8. Lee YJ, Oh SJ. Calculi in the Prostatic Surgical Bed as a Complication after Holmium Laser Enucleation of the Prostate. Endourology and stone disease. Urol J. 2018; 15:238-241."},{"key":"253658","doi-asserted-by":"crossref","unstructured":"9. Siener R, Struwe F, Hesse A. Effect of L-Methionine on the Risk of Phosphate Stone Formation. 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Grases F, Costa-Bauza A. Key Aspects of Myo-Inositol Hexaphosphate (Phytate) and Pathological Calcifications. Molecules. 2019; 24:4434.","DOI":"10.3390\/molecules24244434"},{"key":"253663","doi-asserted-by":"crossref","unstructured":"14. De Coninck V, Keller EX, Rodr\u00edguez-Monsalve M, et al. Evaluation of a portable urinary pH meter and reagent strips. J Endourol. 2018; 32:647-652.","DOI":"10.1089\/end.2018.0202"},{"key":"253664","doi-asserted-by":"crossref","unstructured":"15. Ungerer GN, Winoker JS, Healy KA, et al. Mobile and eHealth technologies in the management and prevention of nephrolithiasis: A systematic review. Actas Urol Esp 2024; 48:25-41.","DOI":"10.1016\/j.acuroe.2023.06.010"},{"key":"253665","unstructured":"16. Ruibal Gago L. Alteraci\u00f3n del pH urinario como etiolog\u00eda de granulomas en pacientes urostomizados [Altered urinary pH as an aetiology of granulomas in urostomised patients.]. Arch Esp Urol. 2022; 75:296-299."},{"key":"253666","unstructured":"17. Sarri\u00f3 Sanz P, S\u00e1nchez Caballero L, P\u00e9rez Tom\u00e1s C, et al. Alteraciones metab\u00f3licas y litiasis en pacientes con derivaci\u00f3n ileal ortot\u00f3pica. A prop\u00f3sito de un caso [Metabolic alterations and stones in patients with orthotopic ileal diversions. Case description. 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