Urolithiasis and metabolic syndrome. The pathophysiology of stone formation

Gadjiev, N.K.; Malkhasyan, V.A.; Mazurenko, D.A.; Guseynov, M.A.; Tagirov, Nair S.

doi:10.29188/2222-8543-2018-9-1-66-75

Cited by 7 publications

(1 citation statement)

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“…Мочекаменная болезнь (МКБ) часто рецидивирует из-за сохранения нарушений обмена веществ, являющихся причиной нефролитиаза. Статистические данные отображают частоту рецидивов МКБ, которая составляет 30-40% через 5 лет и 50% через 10 лет [1,4].…”

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The role of calcium metabolism disorders in the formation of different density calculi with calcium oxalate nephrolithiasis

Budanov

Медведев

Курзанов

et al. 2021

Innovacionnaâ medicina Kubani

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Objective To investigate the relationship between calcium metabolism disorders, stone formation inhibitor levels and stone density in primary and recurrent calcium-oxalate nephrolithiasis.Material and Methods Sixty nine patients with urolithiasis were examined, their average age was 41,4 ± 9,5 years. Two main groups were distinguished: Group 1 – primary calcium-oxalate nephrolithiasis (PN), Group 2 – recurrent calcium-oxalate nephrolithiasis (RN). Then each group was divided into two subgroups – A and B according to stone density: 500–1000 HU and from 1000–1500 HU, respectively. Stone density was determined by computed tomography (CT). PTH (parathormone), PTHrP (parathyroid hormone related protein), vitamin D, total blood calcium (Ca), ionized blood Ca, total blood protein, Ca and urine pH were also examined. After the examination, patients underwent surgical removal of the stones.Results It was found that 41.9% of group 1 and 46.9% of group 2 patients had grade I obesity. Average creatinine level in group 2 was 9.7% higher than in group 1 (p < 0.05). Urea level in both groups was not statistically significantly different. Glomerular filtration rate (GFR) was comparable. Groups 2A and 2B had higher PTHrP values (77.61 and 76.98 pg/mL, respectively) combined with relatively high PTH levels (2A – 4.4 pg/mL and 2B – 5.1 pg/mL), relatively low osteopontin concentration (2A – 0.044 pg/ mL, 2B – 1.106 pg/mL), compared to those in group 1 (p < 0.05). Pairwise unidirectional differences between groups 1A and 2A, 1B and 2B were found to correlate positively with density values: for osteopontin: r = 0.992 (p < 0.05); for vitamin D: r = 0.831 (p < 0.05); for blood Ca2+ ions: r = 0.836 (p < 0.05); for urine pH: r = 0.863 (p < 0.05). There was a negative correlation with the daily concentration of urinary calcium ions with the density of concrements: r = -0.663; p < 0.05. The concentration of osteopontin was significantly higher in Group 1B and 2B patients, and it was significantly lower in patients with stones of < 1000 HU density. Higher values of osteopontin concentration were noted in groups 1B and 2B in relation to groups 1A (p < 0.05) and 2A (p < 0.05). The increase of blood Ca2+ ions in patients in groups 1B and 2B in relation to groups 1A (p < 0.05) and 2A (p < 0.05) was also accompanied by higher values of vitamin D.Conclusion Patients with denser stones showed high values of osteopontin and PTHrP in serum and low values of urinary calcium ions, which may lead to the formation of concrements on the matrix with an organic base. Determination of calcium metabolism makes it possible to predict recurrence of KSD in primary calcium oxalate nephrolithiasis and assess the severity of mineral metabolism disorders in recurrent calcium oxalate nephrolithiasis.

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Section: Introductionunclassified

The role of calcium metabolism disorders in the formation of different density calculi with calcium oxalate nephrolithiasis

Budanov

Медведев

Курзанов

et al. 2021

Innovacionnaâ medicina Kubani

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Metabolic disorders and androgen deficiency in the pathogenesis of urolithiasis

Emirgaev,

Tagirov,

Tagirov

et al. 2024

Pediatr (SPb)

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This review summarizes and critically analyzes current data on the pathogenesis of urolithiasis (urolithiasis, nephrolithiasis). Emphasis is placed on such issues as: mechanisms of urinary stone formation; risk factors for stone formation; the role of oxidative stress; the chemical composition of renal stones (and especially oxalates); the role of Randall’s plaques, osteopontin, uromodulin (Tamm–Horsfall protein), α-enolase; and the mechanism of stone formation in the collecting ducts. Insufficiently studied issues of microbiota influence — (a) kidney and urinary tract and (b) gastrointestinal tract are also considered. Attention is paid to new approaches to understanding the pathogenesis and treatment of urolithiasis, namely works on genetics, epigenetics, genetic engineering and proteomics. The imperfection of existing animal models of urolithiasis is shown. The issue of application of androgen replacement therapy in the treatment of patients suffering from urolithiasis is considered separately. The author considers the main theoretical result of his work to be the approval of the idea of urolithiasis as a systemic disease, in which any significant deviation of the internal environment constants violates the delicate balance that ensures the solubility of substances in primary urine and their excretion with secondary urine. The practical result is to confirm the applicability of androgen replacement therapy in the treatment of patients suffering from urolithiasis.

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Retrograde intrarenal surgery in patients with high-density stones

Tursunov

Nazarov

Рычков

2022

Urology reports (St. - Petersburg)

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BACKGROUND: Retrograde intrarenal lithotripsy is a modern method of endoscopic treatment of patients with nephrolithiasis, whereas some aspects of its use remain the subject of discussion. AIM: To reveal the advantages and disadvantages of retrograde intrarenal lithotripsy in patients with nephrolithiasis having high-density calculi. MATERIALS AND METHODS: A retrospective and prospective analysis of treatment of 260 clinical cases of high-density kidney stones by transurethral contact pyelocalicolithotripsy was conducted. In all patients, kidney calculi were diagnosed and detected, ranging in size from 8 to 20 mm (average 15.4 mm) and density from 1105 to 1634 HU. Patients were divided into the main group and control group and further into two subgroups according to the lithotripsy method. The main group underwent transurethral contact pyelocalicolithotripsy according to our improved method and the control group according to the standard method. The main subgroup of ultrasonic lithotripsy and the control subgroup included 80 and 50 patients, respectively. The main subgroup of laser lithotripsy and the control subgroup included 50 and 80 patients, respectively. RESULTS: In 223 (85.8%) patients, it was possible to completely crush the calculi and eliminate them from the urinary tract. The stone-free rate in the main group was 96.9% (126 patients) after the first operation, including 96.2% (n = 77) in the ultrasonic lithotripsy subgroup and 98% (n = 49) in the laser lithotripsy subgroup. In the control group, the SFR value was 74.6% (n = 97), including 72% (n = 36) in the ultrasonic lithotripsy subgroup and 83.2% (n = 61) in the laser lithotripsy subgroup. Intra- and postoperative complications were observed in 74 (28.5%) patients, and none had grade IV and V complications according to the adapted ClavienDindo classification. The frequency of complications was significantly lower in the main group and those who underwent laser lithotripsy. The relationship of postoperative complications with intraoperative damage to the structures of the pelvicalyceal system of the kidney has been established. CONCLUSIONS: Transurethral contact pyelocalicolithotripsy is an effective and relatively safe method of treating patients with nephrolithiasis having high-density calculi. The proposed improved surgical intervention has advantages over traditional methods.

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Urolithiasis and metabolic syndrome. The pathophysiology of stone formation

Cited by 7 publications

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The role of calcium metabolism disorders in the formation of different density calculi with calcium oxalate nephrolithiasis

The role of calcium metabolism disorders in the formation of different density calculi with calcium oxalate nephrolithiasis

Metabolic disorders and androgen deficiency in the pathogenesis of urolithiasis

Retrograde intrarenal surgery in patients with high-density stones

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