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Published on: February 9, 2021
[Prevention of urolithiasis using febuxostat in patients with metabolic syndrome]
V V Protoshchak1, M V Paronnikov1, P A Babkin1
1FGBVOU VO S. M. Kirov Military Medical Academy of the Ministry of Defense of Russian Fed-eration, Saint Petersburg, Russia.
Introduction:
Urolithiasis is a chronic highly recurrent disease. The development of new methods of its pathogenetic treatment and prevention is a priority task of practical urology.
Aim:
To evaluate the clinical efficiency and safety of Febuxostat-SZ and to develop the rec-ommendations for its use in patients with uric acid stones.
Materials And Methods:
The analysis of 525 patients with urolithiasis was carried out. On the basis of a comprehensive examination, they were divided into two groups: in the group 1, pa-tients (n=231) had urolithiasis and metabolic syndrome, while in the group 2 (n=294), only urolithia-sis was diagnosed without metabolic syndrome. In both groups, depending on the stone composi-tion, in addition to general measures, specific stone prevention was carried out, which included die-tary regimen and drug therapy.
Results:
Uric acid excretion after 6 months of therapy in patients with urolithiasis and meta-bolic syndrome decreased from 9.8+/-1.8 to 3.9+/-1.1 mmol/l, urinary excretion of citrates and urine acidity increased from 0.8 +/-0.6 to 2.5+/-0.8 mmol/l and from 5.4+/-0.5 to 6.3+/-0.5, respectively, while serum uric acid level decreased from 451.4+/-15.1 up to 385.2+/-16.2 mmol/l. In the group of patients who, in addition to prescribing stone prevention, underwent correction of the metabolic syndrome, uric acid excretion after 3 months decreased by half: from 9.7+/-1.9 to 5.0+/-1.2 mmol/l, urine pH and citrate excretion increased from 5.4+/-0.4 to 6.3+/-0.5 and from 0.8+/-0.5 to 2.3+/-1.0 mmol/l, respective-ly, while serum uric acid level decreased from 459.5+/-17.7 to 370.9+/-15.1 mmol/l after 6 months of treatment.
Conclusion:
The use of Febuxostat-SZ in the complex therapy of urinary stone disease showed high efficiency in normalizing urine acidity, the level of daily excretion and serum uric acid level, as well as satisfactory tolerability and a minimal profile of side effects.
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