[DIAGNOSIS OF METABOLIC DISORDERS AND METAPHYLAXIS OF RECURRENT CALCIUM OXALATE UROLITHIASIS]

The paper presents the results of the 1-year screening of biochemical parameters of urine in female patient with recurrent calcium urate urolithiasis. Based on the data of quantitative X-ray phase analysis of the composition of stone and a complex of clinical and laboratory examination, reasons for recurrent stone formation were determined. The main reasons included hypocitraturia, hyperosmolarity of urine and uric acid diathesis. Therapy with citrate mixtures and adequate water schedule (daily urine--2-2.5 liters) for 10 weeks allowed to increase the urinary pH, led to 2.5-fold increase in daily urinary citrate excretion and getting rid of residual stones in both kidneys. The effect of citrate therapy lasted for a further six months after drug withdrawal. Subsequently, the daily urinary citrate excretion and pH decreased, but even after 8 months remained still above baseline values. Obviously, for high risk patients it is necessary to define the daily excretion of citrate, and diagnosis of hypocitraturia requires long course therapy with citrate mixtures, with a break ofnot more than six months and obligate maintenance of adequate diuresis.