Number №1, 2012 - page 24-27

Metabolic bone lesions in the background of nephrolithiasis

Yarovoy S.K., Maksudov R.R., Aleksandrov N.S.

Urolithiasis takes one of the first plac¬es in the structure of urological diseas¬es. Kidney and urinary tract stones are detected in 30-45% of patients admit¬ted to urological hospitals.
Significant aspects are direct cor¬relation between the stone chemical structure and increased excretion of any salt, as well as the pH of urine, from which the solubility of the salts is strongly dependent. These patterns are at the basis metaphylcatic measures. Despite the obvious relevance and social importance of the subject the problem of metabolic osteopathy in the background of recurrent neph¬rolithiasis is covered in contempo¬rary publications insufficiently. Most of the information on this subject is contained in reference and educa¬tional publications, original articles are very few.
Domestic and foreign guidelines, the original papers reflect the patho¬physiology of disorders of mineral metabolism in kidney diseases, the causes and manifestations of Fanconi syndrome, in which there is tubular acidosis, aminoaciduria, phospha- turia, polyuria, proteinuria, tubular type, glucosuria. These violations of tubular function may be either con¬genital or acquired.
The possibility of formation of phos¬phate stones, renal osteodystrophy development against the backdrop of the proximal tubule dysfunction (in high phosphaturia renal calculi is natural, as far as a progressive de-crease in bone mineral density, lead¬ing to bone pain, skeletal deformities, fractures).
Schemes of treatment of Fanconi syndrome, phosphate diabetes, renal osteodystrophy are presented. We also present experimental data on the impact of drugs on bone mineral density in patients with recurrent nephrolithiasis.

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