Acetohydroxamic Acid: Clinical Studies of a Urease Inhibitor in Patients With Staghorn Renal Calculi

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Abstract
The hydrolysis of urea by the bacterial enzyme urease pathologically increases urinary ammonia, bicarbonate, carbonate and alkalinity. These factors contribute to the formation of urinary stones and to the virulence of bacteria. Acetohydroxamic acid, a potent inhibitor of urease, was administered to 23 patients with staghorn renal calculi and urea-splitting urinary infection [Proteus, Pseudomonas or Klebsiella]. Urinary ammonia and alkalinity were reduced in every patient. A dose of 1.0 g acetohydroxamic acid daily was well tolerated and effective for 2-12 mo. even in patients with impaired renal function.