DOI: 10.29188/2222-8543-2025-18-2-90-98
For citation:
Prosyannikov M.Yu., Voytko D.A., Golovanov S.A., Sivkov A.V., Konstantinova O.V., Anokhin N.V., Apolikhin O.I., Kaprin A.D. Metabolic conditions of calcium oxalate urinary stones formation. Experimental and Clinical Urology 2025;18(2):90-98; https://doi.org/10.29188/2222-8543-2025-18-2-90-98
Prosyannikov M.Yu., Voytko D.A., Golovanov S.A., Sivkov A.V., Konstantinova O.V., Anokhin N.V., Apolikhin O.I., Kaprin A.D.
Information about authors:
- Prosyannikov M.Yu. – Dr. Sci., Head of Department of urolithiasis of N.A. Lopatkin Scientific Research Institute of Urology and Interventional Radiology – Branch of the National Medical Research Centre of Radiology of the Ministry of Health of Russian Federation; Moscow, Russia; RSCI Author ID 791050, https://orcid.org/0000-0003-3635-5244
- Voytko D.A. – PhD, Senior Researcher of N. Lopatkin Scientific Research Institute of urology and Interventional Radiology – Branch of the National Medical Research Centre of Radiology of the Ministry of Health of Russian Federation; Moscow, Russia; RSCI Author ID 942353, https://orcid.org/0000-0003-1292-1651
- Golovanov S.A. – Dr. Sci., head of clinical laboratory diagnostic group of scientific laboratory department, N. Lopatkin Scientific Research Institute of Urology and Interventional Radiology – Branch of the National Medical Research Centre of Radiology of the Ministry of Health of Russian Federation; Moscow, Russia; RSCI Author ID 636685, https://orcid.org/0000-0002-6516-4730
- Sivkov A.V. – PhD, Deputy Director of N. Lopatkin Scientific Research Institute of Urology and Interventional Radiology – Branch of the National Medical Research Centre of Radiology of the Ministry of Health of Russian Federation, Moscow, Russia; RSCI Author ID 622663, https://orcid.org/0000-0001-8852-6485
- Konstantinova O.V. – Dr. Sci., Chief Researcher at the Department of urolithiasis of N. Lopatkin Scientific Research Institute of Urology and Interventional Radiology – Branch of the National Medical Research Centre of Radiology of the Ministry of Health of Russian Federation, Moscow, Russia; RSCI Author ID 679965, https://orcid.org/0000-0001-6399-9323
- Anokhin N.V. – PhD, Senior Researcher at the Department of urolithiasis of N.A. Lopatkin Scientific Research Institute of Urology and Interventional Radiology – Branch of the National Medical Research Centre of Radiology of the Ministry of Health of Russian Federation; Moscow, Russia; RSCI Author ID 880749, https://orcid.org/0000-0002-4341-4276
- Apolikhin O.I. – Dr. Sci., professor, сor.-member of RAS, director 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, Head of Department BMT-3 of Bauman Moscow State Technical University; Moscow, Russia; RSCI Author ID 683661, https://orcid.org/0000-0003-0206-043X
- Kaprin A.D. – Dr. Sc., professor, academician of RAS, general director of the National Medical Research Centre of Radiology of Ministry of health of Russian Federation, director of P.A. Herzen Institution, Head of Department of Oncology and Radiology named after V.P. Kharchenko of RUDN University; Moscow, Russia; RSCI Author ID 96775, https://orcid.org/0000-0001-8784-8415
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Introduction. The lithogenesis of calcium oxalate stones largely depends on specific metabolic disturbances, which develop under the influence of various endogenous, exogenous, and social factors. To prevent recurrence of the disease, according to the Russian Ministry of Health's clinical guidelines for «Urolithiasis», it is necessary to focus on the levels of lithogenic substances in the blood and daily urine. However, these standard values considered without taking into account their potential to cause the development of urinary stones of a specific chemical composition. Determining such laboratory criteria may help clinicians more reliably prevent the development of urolithiasis.
The aim of this study was to investigate the metabolic conditions underlying the formation of calcium oxalate stones.
Materials and methods. Data from 263 patients (145 men, 118 women) with calcium oxalate stones (>50% of stone composition) aged 18 to 78 years, treated at the N.A. Lopatkin Research Institute of Urology and Interventional Radiology from 2019 to 2023 analyzed. Biochemical analysis of 24-hour urine used to determine levels of calcium, uric acid, phosphorus, magnesium, and pH. Each dependent variable ranked by interval.
Results. The greatest lithogenic effect on the formation of calcium oxalate stones observed when the threshold values are exceeded: calcium 4.8-5.1 mmol/day, uric acid 3.48-3.87 mmol/day (non-linear graph), phosphates 34.4-40.2 mmol/day, magnesium 5.4-6.4 mmol/day and urine pH 4.8-5.5. The following excretion parameters were less significant: calcium up to 3.8-4.35 mmol/day, uric acid - 0.7-1.71 mmol/day, phosphates - up to 34.2 mmol/day, magnesium 0.20-1.49 mmol/day and urine pH 7.1-9.0.
Conclusion. The most significant metabolic conditions for calcium oxalate stone formation are: urinary calcium excretion above 5.8-5.1 mmol/day and urine pH less than 6.0. The highest incidence of wewellite and weddelite observed at pH values of 4.8-5.5 and 5.6-6.0, respectively. Given the influence of urine pH on calcium excretion, correction of urine pH plays a key role in the prevention of calcium oxalate lithogenesis.
