Treatment and Prevention of Urolithiasis in patients with stones of various locations


Treatment and Prevention of Urolithiasis in patients with stones of various locations


Armais Kamalov1,2, Valery Karpov1,2,3, Aleksei Nizov1,2, Igor Otvetchikov3, David Kamalov1,2, Dmitry Ohobotov1,2, Alexander Tivtikyan2

1Moscow Research and Education Center of the Lomonosov Moscow State University, Moscow, Russia; 2Urology and Andrology Department, Lomonosov Moscow State University, Faculty of Fundamental Medicine, Moscow, Russia; 3Urology and Andrology Department, State Budgetary Institution “City Clinical Hospital №17” of the Public Health Department of Moscow, Moscow, Russia


Global Journal of Urology and Nephrology

The study goal was to find the most optimal approach to the treatment of patients with urolithiasis. The study involved 4014 patients with stones of different localization. Patients with benign prostatic hyperplas-ia (BPH) were investigated with IPSS, PSA, and uroflowmetry. 3175 ureteropyeloscopies were performed. Separately, we studied the results of treatment of 427 patients with ureterolithiasis in combination with BPH, which underwent ureterolithotripsy. Percutaneous nephrolithotrip-sy was performed in 412 patients, most of the procedures were per-formed according to the classical technique. The other research purpose was prophylaxis optimization of the recurrent urolithiasis. 152 patients participated in the experimental part. Some of the patients were taken from the clinical part of the study. All patients were with recurrent calci-um oxalate urolithiasis. Patients were divided into two groups: the 1st group (74 patients) did not receive treatment during the follow-up peri-od, the second group (42 patients) received treatment in the volume of thiazide diuretics, water load, citrate mixtures, calcium preparations in-side. During the entire follow-up (6 months), all patients underwent a comprehensive urological examination. Eventually have been estimated that surgery should not be the final stage of treatment of the urolithiasis. Urolithiasis requires constant monitoring of patients, and the priority task of a urologist is to prevent recurrent stone formation. This is achieved through the appointment of adequate conservative therapy, which includes thiazide diuretics, citrate mixtures, calcium preparations, water intake in adequate amount, and if necessary, magnesium prepara-tions. The final choice of conservative treatment depends on the type of stone. The change in the concentration of crystallization inhibitors (biku-nin and osteopontin) is a predictor of an early relapse of the urolithiasis, which can be used in monitoring patients in the postoperative period.


Keywords: recurrent urolithiasis, nephrolithotripsy, ureteroscopy, uro-lithiasis markers, urolithiasis and infravesical obstruction

Free Full-text PDF


How to cite this article:
Armais Kamalov, Valery Karpov, Aleksei Nizov, Igor Otvetchikov, David Kamalov, Dmitry Ohobotov, Alexander Tivtikyan.Treatment and Prevention of Urolithiasis in patients with stones of various locations. Global Journal of Urology and Nephrology, 2018, 1:8. DOI:10.28933/gjun-2018-12-0405


References:
1. Saeed R. Khan, Douglas E. Rodriguez, Laurie B. Gower, Manoj Monga. Association of Randall’s Plaques with Collagen Fibers and Membrane Vesicles. Journal of Urology. V.187, №3, 2012 Mar, рp.1094–1100.
2. Emmanuel Letavernier, Sophie Vandermeersch, Olivier Traxer, Mohamed Tligui, Laurent Baud, Pierre Ronco, Jean-Philippe Haymann, and Michel Daudon. Demographics and Characterization of 10,282 Randall Plaque-Related Kidney Stones. A New Epidemic? Medicine (Baltimore). Vol. 94, №10, 2015 Mar, pp. 566.
3. Khan S.R., Canales B.K. Unified theory on the pathogenesis of Randall’s plaques and plugs. Urolithiasis. Vol. 43, №1, 2015 Jan, pр.109-123.
4. Lulich J.P., Osborne C.A., Carvalho M., Nakagawa Y. Effects of a urolith prevention diet on urine compositions of glycosaminoglycans, Tamm-Horsfall glycoprotein, and nephrocalcin in cats with calcium oxalate urolithiasis. Am J Vet Res. Vol. 73, №3, – 2012 Mar, – pр.447-451.
5. Michel Daudon, Vincent Frochot. Crystalluria. Clinical Chemistry and Laboratory Medicine (CCLM). Vol. 53, №2, November 2015, pp.1479–1487.
6. Arrabal-Martín M., González-Torres S. Treatment with hydrochlorothiazide and alendronate in patients with stones and bone mineral density loss. Evolution of bone metabolism and calciuria with medical treatment. Arch Esp Urol. Vol.69, №1, 2016 Jan-Feb, pр. 9-18.
7. Tsuji H., Shimizu N., Nozawa M., Umekawa T., Yoshimura K., De Velasco M.A., Uemura H., Khan S.R. Osteopontin knockdown in the kidneys of hyperoxaluric rats leads to reduction in renal calcium oxalate crystal deposition. Urolithiasis. Vol.42, №3, 2014 Jun, рр.195-202.
8. Zharikov A.Y., Motin Y.G., Zverev Y.F., Lampatov V.V., Bryukhanov V.M., Talalaeva O.S. Expression of renal crystallization inhibitors in experimental nephrolithiasis. Bull Exp Biol Med. Vol.153, №2, 2012 Jun, рр.279-82.
9. Malihi Z., Wu Z., Stewart A.W. Hypercalcemia, hypercalciuria, and kidney stones in long-term studies of vitamin D supplementation: a systematic review and meta-analysis. Am J Clin Nutr. Vol.104, №4, 2016 Oct, рр.1039-1051.
10. Barbera M. The importance of citrates in treatment and prophylaxis of calcium oxalate urinary stones. Arch Ital Urol Androl. Vol.88, №4, 2016 Dec, рр.343-344.
11. Kim S.C., Tinmouth W.W., Kuo R.L., Paterson R.F., Lingeman J.E. Simultaneous holmium laser enucleation of prostate and upper-tract endourologic stone procedures // J Endourol. 2004 Dec, – Vol.18, №10, – рр. 971-975.
12. Scarpa R.M., De Lisa A., Porru D., Usai E. Large benign prostatic hyperplasia means impossible ureteroscopy: myth or reality? // Eur Urol. 2000 Apr, – Vol.37, №4, – рр. 381-385.
13. Igci M., Arslan A, Igci Y.Z., Gogebakan B., Erturhan M.S., Cengiz B., Oztuzcu S., Cakmak E.A., Demiryurek A.T. Bikunin and α1-microglobulin/bikunin precursor (AMBP) gene mutational screening in patients with kidney stones: a case-control study // Scand J Urol Nephrol. 2010 Dec, – Vol. 44, №4, – рр. 13-9. doi: 10.3109/00365599.2010.497768. Epub 2010 Jul 5.
14. Icer M.A., Gezmen-Karadag M., Sozen S. Can urine osteopontin levels, which may be correlated with nutrition intake and body composition, be used as a new biomarker in the diagnosis of nephrolithiasis? Clin Biochem. 2018 Sep, – Vol.60, – pp. 38-43. doi: 10.1016/j.clinbiochem.2018.08.001. Epub 2018 Aug 13.