Rationale for metaphylactics calcium oxalate nephrolithiasis taking into account the type of hypercrystalluria

Черненко, В. В.; Черненко, Д. В.; Савчук, В. Й.; Желтовська, Н. І.; Bondarenko, Yu. M.

doi:10.26641/2307-5279.22.4.2018.152488

Cited by 2 publications

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“…Оксидативний стрес -спільна особливість багатьох захворювань, зокрема й серцево-судинних (атеросклерозу, гіпертонічної хвороби, інсулінорезистентності, інфаркту міокарда тощо) [27,28]. Виявили, що активні форми кисню часто утворюються при взаємодії між нирковою тканиною та кристалами кальцію оксалату, фосфату кальцію [29].…”

Section: мета роботиunclassified

“…Відомо, що негативний вплив окисно-модифікованих білків пов'язаний із тим, що вони є основою вільних радикалів, які послаблюють пул клітинних антиоксидантів. За цих умов перекисне окиснення білків є пусковим механізмом оксидативного стресу, а також його раннім підтвердженням [29].…”

Section: мета роботиunclassified

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Modern aspects of comorbidity of urological disease and metabolic syndrome

Hubar¹,

Bilai²,

Білай³

2022

ZMJ

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Urinary stone disease (USD) is one of the most common urological diseases occurring mainly in people of working age. USD is associated with metabolic disorders, the causes of which include endogenous and exogenous factors. Metabolic syndrome (MS) is a “non-infectious epidemic” that manifests itself in diabetes, hypertension, atherosclerosis, and obesity. The bidirectionality of metabolic processes is an important factor of USD and MS. Aim. The paper aims at reviewing modern literary sources regarding the determination of pathogenetic links between the comorbidity of USD and MS. Results. Nephrolithiasis spreads and recurs simultaneously with obesity. A decrease in urine pH, which is the basis for the formation of urate stones, is associated with the presence of obesity, insulin resistance, and MS. Under such conditions, urine alkalinization is the main treatment for urolithiasis. The risk of stone formation increases when the body mass index is more than 30 kg/m2. Among patients with insulin resistance, nephrolithiasis is more severe, and kidney stones occur more often. The relationship between the hypertensive component of MS and USD has been established. Disorders of lipid metabolism have a negative prognosis, causing physicochemical aberrations in urine and the development of nephrolithiasis. Hyperuricemia is related to both the ability of insulin to reduce uric acid clearance in the proximal renal tubules and insulin resistance. The link between USD and chronic inflammation is based on an increase in the endogenous synthesis of oxalates from endogenous glycogenic amino acids, which leads to the development of hyperoxaluria in patients with MS. Clinical studies show the formation of kidney stones in conditions of oxidative stress, an association between stone formation and the development of MS, coronary heart disease, arterial hypertension, which is the result of common pathogenetic characteristics. Conclusions. The comorbidity of USD and MS is a systemic disorder. Kidney stone formation is associated with a decrease in urine pH against the background of MS. Hyperuricemia is comorbid with insulin resistance, dyslipoproteinemia, arterial hypertension, and abdominal obesity. Systemic chronic inflammation, comorbid with obesity and USD, based on an increase in the endogenous synthesis of oxalates from endogenous glycogenic amino acids. Oxidative stress has a common pathogenetic link between stone formation and insulin resistance, atherosclerosis, hypertension, and obesity.

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Section: мета роботиunclassified

Modern aspects of comorbidity of urological disease and metabolic syndrome

Hubar¹,

Bilai²,

Білай³

2022

ZMJ

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“…В ідповідно до сучасних уявлень, сечокам'яна хвороба (СКХ) -одне з найпоширеніших захворювань в урології, при якому в нирках і сечовивідних шляхах відбувається утворення конкрементів [1][2][3]. Це одна з тих патологій, увага до якої з роками не стає меншою, що обумовлено декількома основними аспектами, один із них -остаточна невизначеність патогенезу, іншийнеухильний розвиток науково-технічного прогресу, в результаті якого запроваджуються новітні технології лікування цієї нозології [4,5].…”

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“…Протягом життя ризик утворення хоча б одного епізоду каменя у чоловіків білої раси становить 12-15%, у жінок -5-6%. Рецидиви хвороби виникають з частотою до 50% [1]. Серед усіх випадків СКХ саме уретеролітіаз діагностують у 20-50% випадків [4,5], у 15-30% пацієнтів із СКХ діагностують двобічний уролітіаз.…”

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“…Конкремент, який утворюється внаслідок порушення обміну речовин, чинить ушкоджуючу дію на тканину нирки, порушує відтік сечі і мікроциркуляцію, супроводжується виникненням та прогресуванням гіпоксично-ішемічних розладів у паренхімі, особливо в її канальцевому відділі [1,9,10]. Як відомо, для оцінювання функціонального стану канальцевого нефротелію найбільш інформативними є ензими сечі, оскільки серед усіх органів сечовидільної системи найбільшим джерелом ензимів сечі є нирки.…”

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Peculiarities of Changes in the Activity Levels of Renospecific Enzymes in the Urine of Patients with Ureterolithiasis

Vozianov,

Chernenko,

Nikulina

et al. 2023

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The objective: to study the peculiarities of changes in the activity levels of the renal specific enzymes N-acetyl-β-D-glucosaminidase (NAG) and β-galactosidase (β-Gal) as indicators of the functional state of the kidney parenchyma in the urine of patients with ureterolithiasis, depending on the mineral composition of the calculi and their localization in the ureter Materials and methods. 81 patients were examined for unilateral ureterolithiasis (45 men, 36 women), the average age of the patients was 43.2±9.7 years. In the studied patients, the stone sizes were on average 1.1±0.38 cm. The activity of NAG and β-Gal was determined in the urine before the stone was removed. All patients were divided into groups: 1st group – 33 patients with calcium oxalate stones, 2nd group – 18 persons with uric acid stones, 4th group – 12 patients with phosphate stones. The control group included 28 practically healthy people. Depending on the location of the calculus, the patients were divided into subgroups: localization of stones in the upper third of the ureter – subgroup 1a (n=17), in the middle third – subgroup 2a (n=23), in the lower third of the ureter – subgroup 3a (n=41). Urine for analysis was obtained during catheterization of the ureter from the side affected by the stone, before the use of medical agents and after physiological urination. Results. The activity levels of NAG and β-Gal in the urine from the side affected by the calculus (renal pеlvis) in 81 patients were statistically significantly different from similar indicators in the urine from the bladder after physiological urination in the same patients (р<0.001–0.02). In the urine of patients with unilateral ureterolithiasis, there were no significant changes in the activity levels of NAG and β-Gal depending on the mineral composition of the calculi, with the exception of patients with phosphate urolithiasis. The intensity of activity levels (both NAG and β-Gal) in the urine of these patients was most high in the upper third of the ureter (group 1a), the less high – in the lower third of the ureter (group 3a), the difference was statistically significant (р<0.001–0.02). Conclusions. The analysis of changes in the levels of urinary activity of NAG and β-Gal allows to objectively assess the functional state of the tubular nephrothelium in patients with ureterolithiasis before surgical intervention, and in the post-treatment period will help to monitor the effectiveness of treatment.

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Rationale for metaphylactics calcium oxalate nephrolithiasis taking into account the type of hypercrystalluria

Cited by 2 publications

References 0 publications

Modern aspects of comorbidity of urological disease and metabolic syndrome

Modern aspects of comorbidity of urological disease and metabolic syndrome

Peculiarities of Changes in the Activity Levels of Renospecific Enzymes in the Urine of Patients with Ureterolithiasis

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