Influence of phytotherapy on metabolic status and urine microbiota in patients with urolithiasis — calcium oxalate nephrolithiasis after shock wave lithotripsy
Background. The study of the problem of urolithiasis in recent years has reached a qualitatively new level in connection with the use of a multidisciplinary approach and the principles of evidence-based medicine. In the domestic literature, there are isolated reports on the meaning and methods of correction of metabolic disorders in urolithiasis. There is still no consensus on the feasibility and effectiveness of preventive methods after the removal of stones. The purpose of the study: assessment of the effect of phytotherapy (Urolesan®) on the metabolic status and urine microbiota in patients with urolithiasis — calcium oxalate nephrolithiasis after shock wave lithotripsy. Materials and methods. In 50 patients with calcium oxalate nephrolithiasis aged 18 to 65 (middle age — 41.1 ± 1.6) years, the effect of Urolesan® on the metabolic status (the impact on urine pH, the level of oxalate, calcium, uric acid excretion, indicators of biochemical blood tests), features of urine microbiota and prevention of the recurrent formation of calculi were studied after shock-wave lithotripsy. Results. An analysis of the dynamics of urine pH, measured on days 2, 5, 10, 20, and 30 of treatment with Urolesan®, showed that the patients undergoing a follow-up examination had a gradual increase in urine pH from 5.80 ± 0.04 to 6.13 ± 0.04 on day 5 (p < 0.05) and up to 6.47 ± 0.04 — on day 30 (p < 0.05). The dynamics of oxalate and calcium urine excretion showed that after a month of treatment with Urolesan®, the daily excretion of oxalate decreased by 1.5 times, and calcium — by 1.2 times compared with baseline (p < 0.05). A positive dynamics is reflected in the indicators of uric acid metabolism. The level of uric acid in blood serum decreased from 397.98 ± 9.48 μmol/l to 339.59 ± 7.64 μmol/l, and in urine — from 4.94 ± 0.15 mmol/l to 4.03 ± 0.08 mmol/l (by 1.2 times) (p < 0.05). After a month of treatment with Urolesan®, bacteriuria was detected in 2 patients during a control bacteriological examination of urine. The results of the study demonstrated the metaphylactic potential of Urolesan® — none of the patients after 6 months of follow-up had recurrent calculus formation. Conclusions. Urolesan® has a positive effect on the metabolic status of patients with urolithiasis — calcium oxalate nephrolithiasis after shock-wave lithotripsy (it normalizes urine pH, reduces oxalate excretion by 1.5 times, calcium and uric acid — by 1.2 times, maintains and improves indicators of biochemical blood tests); eliminates the violation of urine microbiota, reduces the number of patients with bacteriuria; realizes metaphylactic potential, preventing the recurrent formation of stones.
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