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Published on: February 9, 2021
[Urinary factors for calcium urolithiasis and their correction]
1Clinic of Urology and Nephrology, Institute of Postgraduate Medical Education, Tashkent, Uzbekistan.
Abstract:
Drugs for preventing stone formation can be selected based on the average regional indicators, which have features depending on the region of the world.
Aim:
To investigate the features of urinary factors for lithogenesis (UFL) of calcium urolithiasis in Tashkent and evaluate the variants of their pharmacological correction.
Materials And Methods:
The study analyzed data from 779 patients with calcium urolithiasis. Ninety-nine patients with uncomplicated calcium urolithiasis received non-selective preventive pharmacotherapy. Of them, patients of group 1 (n=21), 2 (n=56) and 3 (n=22) received alkaline citrate (AC) for 1 month, phytotherapy (PT) for 2 months, and combined therapy (AC + PT) for 1 month, respectively. Statistics of UFL in 779 patients with calcium urolithiasis were calculated, and the results of non-selective prophylaxis in 99 patients with uncomplicated calcium urolithiasis were analyzed.
Results:
The most common UFLs were hypocitraturia (96.7%), decreased diuresis (96.3%), and hyperoxaluria (92.94%). In the patients of group 1, the treatment resulted in an increase in citrate by 54.14% and urine pH by 18.63%; diuresis did not change, and CaOx decreased by 50.63%. In group 2, there was an increase in citrate by 3.88% (on average for 2 months), urine pH by 10.82%, and diuresis by 32.17%; CaOx decreased by 32.59%. In group 3, citrate increased by 71.52%, urine pH by 18.07%, and diuresis by 34.71%; CaOx decreased by 69.15%. Correction of citraturia was effective in patients with initial hypocitraturia: in 80.95%, 78.6%, and 86.4% in groups 1-3, respectively.
Conclusion:
The findings confirm the potential of empirical therapy based on the average statistical indicators of the region. The combination of AC (Litren) and PT (Canephron N) proved to be most effective: CaOx decreased to a low level, it was possible to compensate for the undesirable effects of prolonged intake of the synthetic drug (AC). Nevertheless, we believe that long-term controlled studies are needed to confirm the validity of this approach, and the results of this study should be regarded as promising.
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