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Eksperimental'naya i klinicheskaya urologiya

Acid-base balance of blood in urolithiasis patients. Study I: bicarbonates

Number №4, 2023 - page 92-101
DOI: 10.29188/2222-8543-2023-16-4-92-101
For citation: Anokhin N.V., Prosyannikov M.Yu., Konstantinova O.V., Golovanov S.A., Voytko D.A., Sivkov A.V., Bekiev Ya.D., Apolikhin O.I., Kaprin A.D. Acid-base balance of blood in urolithiasis patients. Study i: bicarbonates. Experimental and Clinical Urology 2023;16(4):92-101; https://doi.org/10.29188/2222-8543-2023-16-4-92-101
Anohin N.V. Prosyannikov M.Yu. Konstantinova O.V. Golovanov S.A. Voytko D.A. Sivkov A.V. Bekiev Ya.D. Apolihin O.I. Kaprin A.D.
Information about authors:
  • Anokhin N.V. – PhD., Senior Researcher at the Department of urolithiasis of N. Lopatkin Scientific Research Institute of Urology and Interventional Radiology – Branch of the National Medical Research Radiological Centre; Moscow, Russia; RSCI Author ID 8807749, https://orcid.org/0000‑0002‑4341‑4276
  • Prosyannikov M.Yu. – Dr. Sci., head of the department 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 791050, https://orcid.org/0000‑0003‑3635‑5244
  • 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
  • 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
  • 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 Ministry of health of Russian Federation; Moscow, Russia; RSCI Author ID 942353, https://orcid.org/0000-0003-1292-1651
  • 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
  • Bekiev Ya.D. – PhD, head of department 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
  • 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; Moscow, Russia; RSCI Author ID 683661; https://orcid.org/0000‑0003‑0206‑043X
  • Kaprin A.D. – Dr. Sci, 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
6966
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Introduction. Kidneys play a leading role in maintaining acid-base balance. Kidney disorders lead to the acid-base balance violations. Data analysis showed that there are not enough attention to the problem of assessing blood acid-base balance in patients with urolithiasis.

The aim of the first stage of this work was to determine the presence and severity of changes in one of the main indicators of acid-base balance - the level of blood bicarbonate in patients with urolithiasis.

Materials and methods. We analyzed data from 83 patients: 39 men and 44 women aged 18 to 74 years. All patients were prescribed a biochemical blood test, a biochemical analysis of daily urine, blood acid-base balance and stone chemical composition. We studied the relationship of actual serum bicarbonate (actHCO3 - ) and standard bicarbonate (stdHCO3- ) in urolithiasis patients with level of other blood and urine parameters. Statistical analysis was performed using the methods of descriptive statistics, comparative statistical analysis, calculation of the t-test for independent groups, correlation analysis for two variables using the computer program Statistica 10.0 (StatSoft USA).

Results. According to the statistical analysis performed using the calculation of Student's t-test, patients with actual serum bicarbonate [actHCO3- ] <21.0 mmol/l and urine pH>5.8 had lower serum total calcium levels (p<0.05 ), higher serum [Cl-] (p<0.05), higher serum creatinine (p<0.05) and urea (p<0.05), lower serum pH (p<0, 05), serum pCO2 (p<0.05), serum lactate concentration (p<0.05), lower BE (p<0.05) than patients with [actHCO3- ] blood >28.0 mmol/l. Correlation analysis showed that there is a relationship between the level of [actHCO3- ] and indicators of total blood calcium (p <0.05), blood chloride (p<0.05), creatinine and blood urea (p <0.05) and the concentration of calcium and magnesium in the daily urine (p<0.05). There was no statistically confirmed relationship between the level of standard blood bicarbonate [stdHCO3- ] and the concentration of other indicators of blood and daily urine.

Conclusion. Determination of the serum bicarbonate level is necessary to clarify the metabolic state in urolithiasis patients. It is necessary to determine the concentration of actual blood bicarbonate (actHCO3- ) in urolithiasis patients.

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Keywords: urolithiasis; renal tubular acidosis; tubulopathy; acid-base balance; bicarbonate; causes of stone formation; metaphylaxis