Selected issues of chemolitholysis in urate nephrolithiasis
- Authors: Batyushin M.M1
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- Issue: No 1 (2015)
- Pages: 39-42
- Section: Articles
- URL: https://journals.eco-vector.com/2075-3594/article/view/262691
- ID: 262691
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Abstract
Urate stones account for 5-10% of all urinary calculi. The key point in stone formation is the adhesion of the microcrystals of uric acid in the tubular urine to the apical nephrothelial membrane. Urate nephrolithiasis may develop against the background of normal excretion of uric acid in the urine in conditions of reduced ammoniogenesis, leading to a decrease of urinary pH. Nutrition can have a significant impact on the purine metabolism and urine acidity, especially in patients with gout, and is one of the key components of the management of patients with hyperuricemia, but to a lesser extent, affects the risk of uric acid stone formation. In fact, citrate mixture is buffer component causing urinary alkalization by hydrolysis with formation of strong base ions and a weak acid. Blemaren has certain advantages over other citrate mixtures, which include predominance of citric acid over citric salt, as well as significant proportion of potassium hydrogen carbonate as buffer component. Thus, hyperuricosuria and decrease of pH due to lower ammoniogenesis are the main pathogenetic factors for uric acid stone formation. The use of citrate mixtures, especially Blemaren, can effectively control the urate urolithiasis, leading to litholysis and reducing the risk of stone recurrence.
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References
- Jones H.B. On the variations of the acidity of the urine in the state of health // Philos. Trans R. Soc. - 1845. - P. 135.
- Shattock S.G. Prehistoric orpredynastic Egyptian calculus// Trans. Path. Sci. Lond. - 1905. - P. 56-62.
- Scheele C. Examen Chemicum Calculi Urinari // Opuscula. - 1776. - Vol. 2. - P. 73.
- Osler W., Young J. Pentland. Edinburgh & London. The principles and practice of medicine: designed for the use of practitioners and students of medicine. -1892. - P. 765-770.
- Hediger M.A., Johnson R.J., Miyazaki H., Endou H. Molecular Physiology of Urate Transport // Physiology. - 2005. - Vol. 20. - P. 125-133.
- Wiederkehr M.R., Moe O.W. Uric Acid Nephrolithiasis: A Systemic Metabolic Disorder // Clin. Rev. Bone Miner. Metab. - 2011. - Vol. 9(3-4). -P. 207-217.
- Jutabha P., Anzai N, Wempe M.F. Apical Voltage-Driven Urate Efflux Transporter NPT4 in Renal Proximal Tubule // Nucleosides, Nucleotides and Nucleic Acids. - 2011. - Vol. 30. - P. 1302-1311.
- Rima K.M., Huang E., Lieske J.C. Adhesion of uric acid crystals to the surface of renal epithelial cells // Am. J. Physiol. Renal Physiol. - 2000. - Vol. 278. -P. 989-998.
- Lieske J.C., Leonard R., Toback F.G. Adhesion of calcium oxalate monohydrate crystals to renal epithelial cells is inhibited by specific anions// Am. J. Physiol Renal Fluid Electrolyte Physiol. - 1995. - Vol. 268. - P. 604-612.
- Sakhaee K., Adams-Huet B, Moe O.W., Pak C.Y.C. Pathophysiologic basis for normouricosuric uric acid nephrolithiasis // Kidney Int. - 2002. - Vol. 62. - P. 971-979.
- Kamel K.S., Cheema-Dhadli S., Halperin M.L. Studies on the pathophysiology of the low urine pH in patients with uric acid stones // Kidney Int. - 2002. -Vol. 61. - P. 988-994.
- Grases F., Costa-Bauza A., March J.G., Masarova L. Glycosaminoglycans, uric acid and calcium oxalate urolithiasis // Urol. Res. - 1991. - Vol. 19. -P. 375-380.
- Moe O.W. Uric acid nephrolithiasis: proton titration of an essential molecule? // Curr. Opin. Nephrol. Hypertens. - 2006. - Vol. 15. - P. 366-373.
- Cameron M.A., Maalouf N.M., Poindexter J. et al. The diurnal variation in urine acidification differs between normal individuals and uric acid stone formers// Kidney Int. - 2012. - Vol. 81(11). - P. 1123-1130.
- Recurrent Nephrolithiasis in Adults: Comparative Effectiveness of Preventive Medical Strategies. Effective Health Care Program. Comparative Effectiveness Review n.61. U.S. Department of Health and Human Services. - 2013. -P. 232.
- Strohmaier W.L., Wrobel B.M., Schubert G. Overweight, insulin resistance and blood pressure (parameters of the metabolic syndrome) in uric acid urolithiasis // Urol. Res. - 2012. - Vol. 40(2). - P. 171-175.
- Левковский С.Н., Протощак В.В., Джалилов И.Б. Влияние Блемарена на насыщение мочи уратными камнеобразующими соединениями. // Terra Medica. Урология. - 2010. - № 4. - С. 31-35.
- Türk C., Knoll T., Petrik A. et al. Guidelines of Urolithiasis. European Association of Urology. - 2014. - P. 98.
- Сергиенко Н.Ф., Шаплыгин Л.В., Кучиц С. Ф. Цитратная терапия в лечении уратного нефролитиаза // Урология и нефрология. - 1999. -№ 2. - С. 34-36.
- Калинина С.Н., Кореньков Д.Г., Мелконян А.Б. Опыт применения цитратной смеси Блемарен у больных с камнями мочеточников // Клиническая нефрология. - 2013. - № 5. - С. 30-32.
- Глыбочко П.В., Аляев Ю.Г., Рапопорт Л.М. и соавт. Современная консервативная (цитратная) терапия при уратных камнях мочеточников // Урология. - 2014. - № 5. - С. 10-13.
- Дзеранов Н.К., Рапопорт Л.М., Цариченко Д.Г., Фролова Е.А. Литолитическая терапия при уратных камнях мочеточника // Фарматека. - 2011. - № 20. - С. 74-76.
- Lojanapiwat B., Tanthanuch M., Pripathanont C. et al. Alkaline citrate reduces stone recurrence and regrowth after shockwave lithotripsy and percutaneous nephrolithotomy // International Braz. J. Urol. - 2011. - Vol. 37(5). -P. 611-616.
- Barcelo P., Wuhl O., Servitge E. et al. Randomized double-blind study of potassium citrate in idiopathic hypocitraturic calcium nephrolithiasis// J. Urol. -1993. - Vol. 150. - P. 1761-1764.
- Елисеев М.С., Денисов И.С., Барскова В.Г. Клинический опыт применения препарата уралит-У у больных подагрой и нефролитиазом// Современная ревматология. - 2012. - № 1. - С. 44-48.
- Khanna D., Fitzgerald J.D., Khanna P.P. et al. 2012 American College of Rheumatology Guidelines for Management of Gout // Part 1: Systematic Nonpharmacologic and Pharmacologic Therapeutic Approaches to Hyperuricemia Arthritis Care & Research. - 2012. - Vol. 64(10). -P. 1431-1446.
- Демидко Ю.Л., Руденко В.И. Применение Блемарена при нефролитиазе // Фарматека. - 2015. - № 3.
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