A metaphylaxis oxalate urolithiasis in patients with metabolic syndrome

Shestaev A.Yu., Paronnikov M.V., Protoschak V.V., Kormakov V.A., Babkin P.A., Kukushkin A.V., Kushnirenko N.P.

The investigations of the last years have revealed a connection between the urolithiasis (UL) and metabolic syndrome (MS), which represents a complex of interconnected metabolic and cardiovascular risk factors. The direct relation is present between the MS and urolithiasisrelated disturbances: hyperuricosuria, hypercalcemia, hyperoxaluria, hypocitraturia and decreased urine acidity (pH≤5.2). The aim of the study was to improve the results of metaphylaxis in patients with oxalate UL and MS due to the identification of the systemic metabolic disturbances and their treatment.

The study data included the information on the evaluation and metaphylaxis in 153 patients with oxalate UL and MS (86 male and 67 female patients). Patients were divided into two groups. Study group included 72 patients with UL and MS, which were treated using UL metaphylaxis and corrected for MS disturbances. Control group was composed of 81 patients with oxalate UL and MS, which did not receive any therapy against possible disease relapse. Recurrence prevention therapy was applied with the aim of correction of metabolic storages. The absence of the relapse during the follow-up of 5 years in control group was detected in 44% of the patients, whereas metaphylaxis in patients with UL and concurrent abdominal form of obesity, diabetes type 2, arterial hypertension and dyslipidemia was able to increase this relapse-free rate up to 75%. Drawing a conclusion, treatment of the patients with oxalate UL and metabolic syndrome together with the active dynamic monitoring by the other specialists could decrease the risk of the recurrent stone formation at 31%.

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