[The proteolysis-ion theory of the pathogenesis of nephrolithiasis]

A study was made of urinary proteolysis. This parameter turned to be decreased in patients with nephrolithiasis versus normal subjects. The authors developed an original proteoclastic-ion theory of nephrolithiasis pathogenesis, based on the two main risk factors triggering the disease: low levels of urinary proteolysis leading to the formation of a calculous matrix; the urine pH values optimal for the sedimentation of lithiasic salts. The combination of both risk factors was responsible for the development of calculous crisis and the formation of microlith. The decreased index of urinary proteolysis calculated with the formula offered could be regarded as a risk indication to the microlith formation. A possible elimination of the both risk factors was demonstrated. The technique of microlithiasis metaphylaxis was developed with regard to the major and minor risk factors and the possibility of their elimination. The values of urinary proteolysis were the criteria for a successful therapeutic response. With regard to the number of risk factors the risk of primary nephrolithiasis or lithiasis relapses could be predicted.