Treatment of patients with oxalate urolithiasis after extracorporeal shock wave lithotripsy of ureteral calculi

Abstract

The frequency of recurrence of urolithiasis within the first 3 years after treatment reaches 53%, of which more than half of cases are detected in the first year of follow-up. In the remote period of observation, the frequency of recurrent stone formation reaches 77%.The objective: to evaluate the metaphylactic effect of phytotherapy in patients with oxalate urolithiasis after extracorporeal shock wave lithotripsy (ESWL) of the ureteral calculi.Materials and methods. The clinical study was conducted as a non-interventional open controlled, in two groups of patients with initial state control. The study included 64 patients with urolithiasis, oxalate concreting ureter, who performed one session of ESWL and achieved complete fragmentation of the stone. All patients of the main group (n = 32) were prescribed basic therapy + herbal medicine for 1 month with a repeat treatment at 6 months. Patients of the control group (n = 32) received baseline therapy without the study drug. The duration of follow-up is 12 months.Results. After 12 months of observation in the patients of the main group, the concentration of citrates in the urine was 2.67 ± 0.14 mmol / L compared with 2.32 ± 0.11 mmol / L in the control group (p <0.05). In patients of the main group, the daily excretion of oxalates after 12 months of observation was reduced to 38.4 ± 3.45 mg / d compared with the control group patients - 50.1 ± 2.56 mg / d (p <0.05). After 12 months of observation, a consistently high diuresis was noted in the patients of the main group 1.96 ± 0.24 l / d compared with patients of the control group 1.62 ± 0.12 l / d (p <0.05). The concentration of uric acid in the urine of the patients of the main group decreased to 4.42 ± 0.27 mmol / L, in patients of the control group - up to 4.59 ± 0.22 mmol / l. After 12 months of observation, the serum uric acid concentration was 0.210 ± 0.64 ?mol / l in patients of the main group and 0.305 ± 0.73 ?mol / l in the control group (p <0.05).Conclusion. Results of examination after 12 months of metaphylactic treatment of patients of the main group with oxalate nephrolithiasis showed no recurrent stone formation, in the control group 3 (9.4%) of the patient with recurrent formation of concrements up to 5 mm in the pulmonary calcification system of the kidney (p <0.05 ). The obtained results confirm the pathogenetic mechanisms of the action of phytopreparation Urolesan® on risk factors for oxalate nephrolithiasis, which is manifested in the stable normalization of the risk factors of this pathology