Kogut V. The hypocitraturia and hyperuricosuria correction at complex prophylactic of recurrent renal stone formation at people with hyperoхaluric nephrolithiasis.

The work is dedicated to perfection of methaphilactic of hyperoхaluric nephrolithiasis, which is the most prevailing type of urolithiasis. Approximately 70 - 85 per cent of kidney stone is salt of oxalic acid. The characteristic feature of any type of nephrolithiasis is a very high percentage of recurrent stone formation, especially in early period after release of superior urinary tract from stones. As a result the aim of our work was to increase effectiveness of methaphilactic treatment of patients with hyperoхaluric nephrolithiasis by using citrate preparations, taking into consideration risk factors and methods of extraction of stones from urinary tract, which allowed to reduce essentially the percentage of recurrent nephrolithiasis. It was examined 206 patients with different types of nephrolithiasis. Metaphilactic methods were used in group with hyperoхaluric nephrolithiasis, which was consisted of 138 patients; in 106 patients citrate preparations were used. It was investigated risk factors ofnephrolithiasis: pH of urine, hypocitraturia, hyperuricosuria, hyperoxaluria, diurnal diuresis. It was established that excretion of citrate of urine arises for certain during treatment with citrate preparations independently of method of extraction of stones from urinary track. Moreover the dynamics of reducing of urine citrate after cessation of citrate therapy is independent of duration of citrate therapy. It was established the minimal period of usage of citrate preparations in plan of methaphilactic treatment of hyperoхaluric nephrolithiasis dependently on method of extraction of stones from urinary track. So, if the stone came out without any assistance, this period would be no less then 2 months, but other methods of removing stone obstruction could prolong this period till 6 months. Taking into consideration, that risk of recurrent stone formation is the highest during first year after removing stones from superior urinary track, in this case it is necessary to do citrate therapy during 12 months fromthe moment of removing stone. According to results of personal clinical investigations the scheme of methaphilactic of hyperoхaluric nephrolithiasis was scientifically founded by instituting citrates not constantly, but cyclically (10 days of therapy, 10 days of rest), which is guarantee disappearance of hypocitraturia and reduction of risk of recurrent stone formation. Usage of citrate therapy in complex methaphilactic measures allowed to reduce recurrent stone formation in 1,9%, in compression with 9,4% in control group, where only traditional methods of methaphilactic were used.