The pH of normal urine is generally in the range 4.6 - 8, a typical average being around 6.0
much of the variation is due to diet
for example, high protein diets result in more acidic urine, but vegetarian diets generally result in more alkaline urine (both within the typical range 4.6 - 8)
alkaline urine is associated with infection with urease-splitting organisms (e.g. Proteus, Klebsiella)
urea splitting bacteria are related to the formation of struvite-apatite
struvite stones are potentiated by bacterial infection that hydrolyzes urea to ammonium and raises urine pH to neutral or alkaline values
upper urinary tract stones that involve the renal pelvis and extend into at least 2 calyces are classified as staghorn calculi
although all types of urinary stones can potentially form staghorn calculi, approximately 75% are composed of a struvite-carbonate-apatite matrix
urine pH generally reflects the blood pH but this is not the case in renal tubular acidosis (RTA)
type 1 RTA (distal) the urine is acidic but the blood alkaline
type 2 RTA (proximal) the urine is initially alkaline
however urine becomes more acidic as the disease progresses
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