Therapeutic modalities for litholysis using citrate drugs in patients with urolithiasis

A.I. Neymark, B.A. Neymark, N.A. Nozdrachev, A.V. Davydov, I.V. Kablova

Altai State Medical University, Barnaul

Aim: to assess the efficacy and safety of complex citrate-containing drug in patients with urolithiasis.

Patients and Methods: patients with the stones in the upper third of the ureter or ureteropelvic junction stones were enrolled in the study. All patients underwent ureteric stenting and received anti-inflammatory treatment course. 30 patients were included in the study group while 27 patients comprised the control group. Study group patients additionally received citrate-containing drug (potassium bicarbonate + citric acid + sodium citrate) for 4 weeks, initial dosage was 3 g daily (this dosage was adjusted based on the urinary pH). 28 days after ureteric stenting, all patients underwent extracorporeal shock wave lithotripsy, and the drainage was removed.

Results: in the study group, blood levels of uric acid significantly reduced while no significant changes in this parameter were revealed in the control group. Signi ficant decrease in the sizes of the stones (from 1.7 cm to 0.7 cm) was demonstrated in the study group by the second visit. Moreover, in 5 patients, the stones were completely dissolved by the second visit. As a result, we managed to avoid extracorporeal shock wave lithotripsy. In the control group, standard treatment did not result in the decrease in the sizes of the stones by the second visit. Therefore, the sizes of the stones were significantly greater after extracorporeal shock wave lithotripsy as compared with the study group. No allergic reactions in both groups were reported.

Conclusions: complex citrate-containing drug can be used for kidney-stone therapy both to dissolve the stones completely as well as to prepare for extracorporeal shock wave lithotripsy. This drug is characterized by high safety which is important for kidney-stone therapy.

Keywords: urolithiasis, extracorporeal shock wave lithotripsy, citrate therapy, complex citrate-containing drug.

For citation: Neymark A.I., Neymark B.A., Nozdrachev N.A. et al. Therapeutic modalities for litholysis using citrate drugs in patients with urolithiasis. RMJ. 2019;11:8–11.