PERSPECTIVES OF METAPHYLAXIS OF NEPHROLITHIAS RECURRENCE AND RECOVERY OF KIDNEY FUNCTION IN PATIENTS WITH KIDNEY DISEASE

Анотація

During the last decades, there have been qualitative changes in the treatment of urolithiasis, which are associated with the introduction of highly accurate methods of diagnosing the disease and minimally invasive methods of removing urinary stones into the wide urological practice. However, the medical and social significance of urolithiasis has not decreased, and the incidence of urolithiasis continues to increase in almost all countries of the world. There is no doubt about the successful use of modern technologies in the treatment of urolithiasis, but their possibilities are not limitless. All this creates conditions for finding new forms and methods of complex treatment of urolithiasis. Urolithiasis has a pronounced tendency to relapse due to the lack of effective pathogenetic methods of treatment. According to various authors, the total rate of urinary stone recurrence is 14% in the first year of observation, 35% in the fifth year, and 52% by the 10th year. All this creates conditions for finding new forms and methods of complex treatment of urolithiasis. The effectiveness of the treatment of urolithiasis is not limited to one goal - to rid the patient of urolithiasis from any localization and does not guarantee the absence of recurrences of stone formation. Urinary stone disease is a complex polyetiological disease, the basis of which is a whole series of metabolic disorders, as a result of which urinary calculi are formed. Most often, these are individual features of disorders inherent in each organism, which significantly complicates the effectiveness of treatment of this disease. Treatment of urolithiasis should be pathogenetic, not symptomatic, and should be aimed at recurrence-free treatment. Treatment in the period following stone removal (destruction) must necessarily be aimed at rehabilitation of kidney function and metaphylaxis of this disease. The modern concept of metaphylaxis of urolithiasis requires a mandatory study of the mineral composition of urolithiasis and further diagnosis of lithogenic disorders depending on the type of calculus. Determination of these factors is the basis for assessing the degree of risk of developing nephrolithiasis or its recurrence. This approach makes it possible to determine the cause of stone formation and purposefully prescribe anti-recurrence therapy, which reduces the risk of repeated stone formation by 10-15%.