Dynamics of Restoration of Functional State of the Kidney Parenchyma and Normalization of Main Risk Factors of Calcium-oxalate Nephrolithiasis in Urine on the Background of Using Complex Metaphylaxis

Abstract

The objective: to investigate the dynamics of restoration of the functional state of the renal parenchyma by levels of N-acetyl-β-D-glucosaminidase (NAG) activity in urine and normalization of the main risk factors of calcium-oxalate nephrolithiasis (Ca-Ox NL) – by concentrations of calcium, oxalic and uric acids in urine on the background of application of complex metaphylaxis within a year after stone removal.Materials and methods. 45 patients with Ca-Ox NL before and after the removal of concrements in 1, 3, 6 and 12 months on the background of the use of complex metaphylaxis were examined. The activity of the conditionally renospecific enzyme NAG and concentration of calcium, oxalic and uric acids were analyzed. The personification of metaphylactic measures was performed depending on the characteristics of the risk factors for the development of Ca-Ox NL: the combination of hyperoxaluria with hyperuricemia and hyperuricuria, the combination of hyperoxaluria with hyperuricemia, the presence of significant hyperoxaluria on the background of normouricemia and normouricuria and also depending on hypercalciuria. The control group consisted of 28 practically healthy persons with normal analysis of urine and free of renal diseases.Results. In patients with NL before the removal of the stone, the activity of NAG, calcium, oxalic and uric acid concentrations probably exceeded the control data. In the dynamics of observation there is a gradual decrease in urinary NAG activity, calcium, oxalic and uric acid concentrations. NAG activity and uric acid concentration did not differ from the data in the control group after 12 months, calcium – after 3 months, oxalic acid concentration after 6 months.Conclusion. Restoration of the functional state of tubular nephrotheoia and normalization of concentrations of the main risk factors for the development of Ca-Ox NL on the background of complex metaphylaxis was achieved in almost 95 % of cases. The obtained results can be used to correct and optimize the treatment tactics of patients with Ca-Ox NL after removal of the calculus during the year.