31st July 2023

A 65-year-old man presents to an outpatient clinic, complaining of bilateral loin pain radiating to the groin

A 65-year-old man presents to an outpatient clinic, complaining of bilateral loin pain radiating to the groin, dysuria and urgency. He denies any history of blood in his urine. Bloods show a calcium level of 2.2 mmol/L, uric acid 360 umol/L and creatinine 88 umol/L. Ultrasound imaging shows an echogenic area, with shadowing in the left kidney. Plain x-ray shows no evidence of renal calculi. A 24-hour urinary test revealed a uric acid level of 780mg (normal < 750). Urinalysis showed urine pH of 5.0.

Which of the following is the most appropriate prophylactic treatment for this patient?

Select the SINGLE most appropriate option from the list below. Select ONE option only.