THE ROLE OF ALKALINE CITRATES IN THE METAPHYLAXIS OF UROLITHIASIS


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Abstract

Introduction: The use of citrate mixtures plays an important role in the prevention of stone formation. In patients with urolithisis, most studies show the effect of potassium citrate preparations exclusively. Potassium-sodium and sodium-citrate mixtures have been registered in the Russian Federation, the effect of which on the metabolism of stone-forming substances has not been fully studied. Objective: To determine the effect of the sodium-citrate mixture «Blemaren® «on the state of metabolism of lithogenic substances in patients with urolithisis Materials and methods: 46 patients of the general group (26 men and 20 women) aged 18 to 65 years with a diagnosis of urolithisis took Blemaren® (hereinafter referred to as the Drug) 3 g 3 times a day for 2 weeks. As a control of the indicators, patients measured the pH of urine 3 times a day using test strips, and also twice (at the beginning of the study and 14 days after the start of taking the drug) performed a biochemical analysis of blood and daily urine. To determine changes depending on the initial pH level of urine, patients of the general group weredivided into 2 subgroups: subgroup 1 <6.2 (n=34) and subgroup pH >6,2, but <6.8 (n=12). Statistical analysis of the data obtained was carried out using the Student and Wilcoxon criteria using the computer program Statistica 12.0 (StatSoft USA). Results: In the general group, statistically significant changes in blood serum levels of sodium and chlorides were observed against the background of taking the Drug, but within the reference values (p<0,05). The levels of excretion of the studied substances showed an increase in the level of potassium and citrates, an increase in the average daily pH of urine and a decrease in the level of excretion of total calcium (p<0,05). In patients with urine pH <6,2, statistically significant changes were noted against the background of taking the drug: a decrease in the level of excretion of total calcium, an increase in the level of excretion of potassium and citrates, as well as the average daily pH level (p<0.05). In patients with urine pH >6.2, but <6.8 significant changes in the excretion of lithogenic substances, except for an increase in the level of citrates and sodium, were not detected. Conclusion: The use of the drug «Blemaren®» in patients with urolithiasis with urine pH<6.2 before treatment significantly reduces serum concentrations of sodium and chlorides within reference values, renal daily excretion of total calcium and increases the levels of renal daily excretion of potassium, citrates and urine pH. In patients with urine pH greater than or equal to 6,2, but less than 6,8 before treatment, without urinary urease-producing microflora, the drug «Blemaren®» increases the levels of renal daily excretion of sodium and citrates.

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About the authors

M. Yu Prosyannikov

National Medical Research Centre of Radiology of the Ministry of Health of Russian Federation

Email: prosyannikov@gmail.com
Ph.D., Head of Department of urolithiasis of N.A. Lopatkin Scientific Research Institute of Urology and Interventional Radiology - Branch Moscow, Russia

O. V Konstantinova

National Medical Research Centre of Radiology of the Ministry of Health of Russian Federation

Email: konstant-ov@yandex.ru
MD, Chief Researcher at the Department of urolithiasis of N.A. Lopatkin Scientific Research Institute of Urology and Interventional Radiology - Branch Moscow, Russia

S. A Golovanov

National Medical Research Centre of Radiology of the Ministry of Health of Russian Federation

Moscow, Russia

N. V Anokhin

National Medical Research Centre of Radiology of the Ministry of Health of Russian Federation

Email: anokhinnikolay@yandex.ru
Ph.D., Researcher of the Department of urolithiasis of N.A. Lopatkin Scientific Research Institute of Urology and Interventional Radiology - Branch Moscow, Russia

D. A Voitko

National Medical Research Centre of Radiology of the Ministry of Health of Russian Federation

Email: 1987vda@mail.ru
Ph.D., Researcher of the Department of urolithiasis of N.A. Lopatkin Scientific Research Institute of Urology and Interventional Radiology - Branch Moscow, Russia

A. V Sivkov

National Medical Research Centre of Radiology of the Ministry of Health of Russian Federation

Email: uroinfo@yandex.ru
Ph.D., Deputy Director on scientific work of N.A. Lopatkin Research Institute of urology and Interventional Radiology -branch Moscow, Russia

O. I Apolikhin

National Medical Research Centre of Radiology of the Ministry of Health of Russian Federation

Email: apolikhin.oleg@gmail.com
corresponding member of RAS, Ph.D., MD, professor, Director of N.A. Lopatkin Research Institute of urology and Interventional Radiology - branch Moscow, Russia

A. D Kaprin

National Medical Research Centre of Radiology of the Ministry of Health of Russian Federation; Peoples’ Friendship University of Russia

Email: contact@nmicr.ru
Ph.D., MD, Academician of the RAS, professor, Director General of FSBI National Medical Research Radiologmal Center of Minzdrav of Russia, Director of Herzen Moscow Research Oncological Institute, Head of the Department of the Oncology and Interventional Radiology named after V.P. Kharchenko of Peoples' Friendship University of Russia Moscow, Russia

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