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Тhe impact of therapy for chronic heart failure on the lithogenic properties of urine DOI: 10.29188/2222-8543-2023-16-4-112-119
- Royuk R.V. – PhD, Head of the urological department of branch No. 1 of the Federal State Budgetary Institution «GVKG named after. N.N. Burdenko» of Ministry of Defense; Moscow, Russia; RSCI Author ID 1001272, https://orcid.org/0000‑0002‑8335‑030X
- Yarovoy S.K. – Dr. Sci., professor, Pletnev‘s municipal clinical hospital of the dept. of health service, Moscow; leading researcher of N. Lopatkin Scientific Research Institute of Urology and Interventional Radiology – branch of the National Medical Research Centre of Radiology of Ministry of health of Russian Federation; Moscow, Russia; RSCI Author ID 50022, https://orcid.org/0000‑0003‑4543‑1480
- Grishina N.V. – Head of the Cardiology Department of Pletnev‘s municipal clinical hospital of the dept. of health service; Moscow, Russia; RSCI Author ID 1203293
- Kareva E.N. – Dr. Sci., Professor of the Department of Pharmacology, Institute of Biodesign and Modeling of Complex Systems, Scientific and Technological Park of Biomedicine of Sechenov University; Moscow, Russia; RSCI Author ID 49115
- Martov A.G. – Dr. Sci., professor, Corresponding Member of the RAS, Head of the Department of Urology, Institute of Advanced Studies of the Federal Medical and Biological Agency (FMBA); Moscow, Russia; RSCI AuthorID 788667, https://orcid.org/0000‑0001‑6324‑6110
297 Introduction. In cardiology practice, a considerable number of drugs, having evident metabolic effects, are used, including those that impact on the process of stone formation.
The Research Aim. To study the effects of cardiotropic drugs that can affect the likelihood of recurrence of nephrolithiasis.
Materials and Methods. The retrospective study was performed on 49 patients suffering from recurrent urate nephrolithiasis and drug-compensated chronic heart failure, who were treated in branch No. N.N. Burdenko” MO in 2018-2022. Two groups of patients were examined, according to the scheme of cardiotropic therapy: group I - losartan, bisoprolol, atorvastatin, clopidogrel, spironolactone, dapagliflozin (n=25); Group II - enalapril, bisoprolol, atorvastatin, acetylsalicylic acid, spironolactone (n=24). Duration of observation is 3 months.
Results. When using the scheme based on losartan and dapagliflozin (Group I), a significant decrease in the serum concentration of uric acid and a simultaneous increase in its renal excretion against the background of increased diuresis and a decrease in urine acidity were revealed compared with patients who received the scheme based on enalapril (II group). There were no significant differences between the groups in terms of the risk of decompensation of chronic heart failure, recurrence of stone formation and the frequency of episodes of urinary tract infection.
Conclusion. Сardiotropic therapy has a significant effect on the properties of urine in patients with nephrolithiasis. None of the approaches studied demonstrated either overwhelming advantages or disqualifying disadvantages. Both of them have the right to exist. Despite the uricosuric effect, the use of dapagliflozin for the treatment of chronic heart failure in patients with urate nephrolithiasis was not accompanied by an increase in the frequency of recurrence of stone formation.
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