Object - pathogenesis and treatment of nephrolithiasis; purpose - to find out the functional state of the kidneys, cytokines, cystatin C, fibrinolytic and proteolytic urine activity in patients with nephrolithiasis in the presence of renal stones in the range of 0,6 - 1,0 cm of the upper, middle calyx and upper third of the ureter with the development of pathogenetic correction pathways detected change with the use of the device of litotriptor and citrate mixture; methods - general clinical, X-ray, immunonephelometric, biochemical, immunoenzymatic, chemical, and statistical; results - it was established that for the development of nephrolithiasis with the size of concrement 0,6-1,0 cm of the upper area of the calyx, changes in the function of the kidneys were characterized by the development of retinal azotemia, proteinuria, hyponatremia, inhibition of distal reabsorption of sodium ions, increased excretion of titrated acids, hydrogen ions , ammonia, ammoniacal factor; for the development of nephrolithiasis with the size of concrement 0,6-1,0 cm of the middle cup - the development of proteinuria, inhibition of distal reabsorption of sodium ions, increased glomerular filtration rate, ammonia excretion and ammonia coefficient; for the development of nephrolithiasis with the size of concrement 0,6-1,0 cm of the upper third of the ureter - an increase in excretion of potassium ions, creatinine, glomerular filtration velocity, inhibition of distal reabsorption of sodium ions, increased excretion of titrated acids, concentration and excretion of urinary ion ions; It is proved that for the development of nephrolithiasis, the dysfunction of the glomerular-tubular and tubular-canal balance increases in such sequence: the upper third of the ureter with the tendency to increase the correlation force of the relative reabsorption of water with glomerular filtration, absolute, proximal reabsorbtion of sodium ions; middle cup with the establishment of two new negative correlation dependencies of diuresis, distal reabsorption of sodium ions with a relative reabsorption of water; upper cup with the formation of eight new negative correlation dependencies in the structure of the glomerular-tubular and tubular-canal balance; It was established that the concentration of cystatin C in the blood plasma after conducting sessions of shock-wave lithotripsy of renal stones in the size of 0,6-1,0 cm in the upper third of the ureter was not changed and decreased under the conditions of the renal stones of the upper and middle sections of the cup; the degree of growth of dysfunction of the fibrinolytic activity of the urine in such a sequence is established: the upper third of the ureter, the middle and upper parts of the cup; An increase in the concentrations of tumor necrosis factor-α, interleukin-1β in the plasma of the blood before and after the sessions of shock-lithotripsy renal stones in the size of 0,6-1,0 cm in the upper portion of the cup and the increase in the concentration of tumor necrosis factor-α in the blood plasma up to a shock-wave lithotripsy session in the presence of a concrement in the middle region of the cup; the degree of growth of dysfunction of blood plasma cytokines for nephrolithiasis in such a sequence is established: the upper third of the ureter, the middle and upper parts of the cup; shows that the use of application of citrate mixture in conditions of nephrolithiasis after shock wave lithotripsy sessions shows protective protector properties that are characterized by a decrease in proteinuria, level of tumor necrosis factor-α, normalization of distal ion transport parameters, fibrinolytic urine activity, restriction of disruption of stone-forming activation of urinary acid secretion.
