https://doi.org/10.4081/aiua.2026.15985
Phytate and L-methionine for preventing recurrence of infection renal stones
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Accepted: 25 July 2026
Published: 28 September 2026
Background: Urine acidification and inhibition of crystallization are strategies that can be employed to prevent recurrent infection stones and calcium phosphate stones.
Methods: 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.
Results: 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.
Conclusions: 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.
Downloads
1. Grases F, Costa-Bauzá A, Gomila I, et al. Urinary pH and renal lithiasis. Urol Res. 2012; 40:41-6. DOI: https://doi.org/10.1007/s00240-011-0389-3
2. Bichler KH, Eipper E, Naber K, et al. Urinary infection stones. Int J Antimicrob Agents. 2002; 19:488-98. DOI: https://doi.org/10.1016/S0924-8579(02)00088-2
3. Klee LW, Brito CG, Lingeman JE. The clinical implications of brushite calculi. J Urol. 1991; 145:715-8. DOI: https://doi.org/10.1016/S0022-5347(17)38432-X
4. Krambeck AE, Handa SE, Evan AP, Lingeman JE. Profile of the brushite stone former. J Urol. 2010; 184:1367-71. DOI: https://doi.org/10.1016/j.juro.2010.05.094
5. Siener R, Netzer L, Hesse A. Determinants of brushite stone formation: a case-control study. PLoS One. 2013; 8:e78996. DOI: https://doi.org/10.1371/journal.pone.0078996
6. Evan AP, Lingeman JE, Coe FL, et al. Crystal-associated nephropathy in patients with brushite nephrolithiasis. Kidney Int. 2005; 67:576-91. DOI: https://doi.org/10.1111/j.1523-1755.2005.67114.x
7. Tsai P, Maalouf NM. Calcium Phosphate Nephrolithiasis: A Comprehensive Review. Kidney Med. 2026; 8:101301. DOI: https://doi.org/10.1016/j.xkme.2026.101301
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.
9. Siener R, Struwe F, Hesse A. Effect of L-Methionine on the Risk of Phosphate Stone Formation. Urology. 2016; 98:39-43. DOI: https://doi.org/10.1016/j.urology.2016.08.007
10. Hesse A, Heimbach D. Causes of phosphate stone formation and the importance of metaphylaxis by urinary acidification: a review. World J Urol. 1999; 17:308-15. DOI: https://doi.org/10.1007/s003450050152
11. Grases F, Costa-Bauzá A, Calvó P, et al. Phytate Dephosphorylation Products Also Act as Potent Inhibitors of Calcium Oxalate Crystallization. Molecules. 2022; 27:5463. DOI: https://doi.org/10.3390/molecules27175463
12. Calvó P, Costa-Bauza A, Grases F. Effect of Phytate (InsP6) and Other Inositol-Phosphates (InsP5, InsP4, InsP3, InsP2) on Crystallization of Calcium Oxalate, Brushite, and Hydroxyapatite. Biomolecules. 2023; 13:1061. DOI: https://doi.org/10.3390/biom13071061
13. Grases F, Costa-Bauza A. Key Aspects of Myo-Inositol Hexaphosphate (Phytate) and Pathological Calcifications. Molecules. 2019; 24:4434. DOI: https://doi.org/10.3390/molecules24244434
14. De Coninck V, Keller EX, Rodríguez-Monsalve M, et al. Evaluation of a portable urinary pH meter and reagent strips. J Endourol. 2018; 32:647-652. DOI: https://doi.org/10.1089/end.2018.0202
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: https://doi.org/10.1016/j.acuroe.2023.06.010
16. Ruibal Gago L. Alteración del pH urinario como etiología de granulomas en pacientes urostomizados [Altered urinary pH as an aetiology of granulomas in urostomised patients.]. Arch Esp Urol. 2022; 75:296-299.
17. Sarrió Sanz P, Sánchez Caballero L, Pérez Tomás C, et al. Alteraciones metabólicas y litiasis en pacientes con derivación ileal ortotópica. A propósito de un caso [Metabolic alterations and stones in patients with orthotopic ileal diversions. Case description. Arch Esp Urol. 2021; 74:351-354
Ethics Approval
CRediT authorship contribution
Conceptualization, B.I. and A.T.; methodology, A.T.; software, N/A.; validation, B.I.; formal analysis, A.T.; investigation, data curation and writing B.B.C., A.F., E.M.A., J.M.A., M.M., C.M.B., A.P., A.V., M.P.A.G., A.Z.Z., C.A.V., G.B.S., L.L.H., A.C.L., G.A.P., A.M., M.C.S., M.P.L., A.S.; writing - review and editing, A.T.; visualization, A.T..; supervision, B.I.; project administration, N/A; funding acquisition, N/A. All authors have read and agreed to the published version of the manuscript.
Supporting Agencies
Data Availability Statement
Availability of data and material: All inquiries can be directed to the corresponding author.
How to Cite

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.