Urinary stone disease (USD) is one of the most common urological diseases occurring mainly in people of working age. USD is associated with metabolic disorders, the causes of which include endogenous and exogenous factors. Metabolic syndrome (MS) is a “non-infectious epidemic” that manifests itself in diabetes, hypertension, atherosclerosis, and obesity. The bidirectionality of metabolic processes is an important factor of USD and MS. Aim. The paper aims at reviewing modern literary sources regarding the determination of pathogenetic links between the comorbidity of USD and MS. Results. Nephrolithiasis spreads and recurs simultaneously with obesity. A decrease in urine pH, which is the basis for the formation of urate stones, is associated with the presence of obesity, insulin resistance, and MS. Under such conditions, urine alkalinization is the main treatment for urolithiasis. The risk of stone formation increases when the body mass index is more than 30 kg/m2. Among patients with insulin resistance, nephrolithiasis is more severe, and kidney stones occur more often. The relationship between the hypertensive component of MS and USD has been established. Disorders of lipid metabolism have a negative prognosis, causing physicochemical aberrations in urine and the development of nephrolithiasis. Hyperuricemia is related to both the ability of insulin to reduce uric acid clearance in the proximal renal tubules and insulin resistance. The link between USD and chronic inflammation is based on an increase in the endogenous synthesis of oxalates from endogenous glycogenic amino acids, which leads to the development of hyperoxaluria in patients with MS. Clinical studies show the formation of kidney stones in conditions of oxidative stress, an association between stone formation and the development of MS, coronary heart disease, arterial hypertension, which is the result of common pathogenetic characteristics. Conclusions. The comorbidity of USD and MS is a systemic disorder. Kidney stone formation is associated with a decrease in urine pH against the background of MS. Hyperuricemia is comorbid with insulin resistance, dyslipoproteinemia, arterial hypertension, and abdominal obesity. Systemic chronic inflammation, comorbid with obesity and USD, based on an increase in the endogenous synthesis of oxalates from endogenous glycogenic amino acids. Oxidative stress has a common pathogenetic link between stone formation and insulin resistance, atherosclerosis, hypertension, and obesity.

The aim of the work is to study the peculiarities of the course of urate nephrolithiasis and urate nephrolithiasis comorbid with metabolic syndrome. Materials and methods. Clinical and laboratory data of 183 patients. The control group of patients with urate nephrolithiasis received traditional therapy. The patients of the main group with urate nephrolithiasis comorbid with metabolic syndrome took quertin and traditional therapy, as well as popular medical drugs that correct metabolic processes. Clinical laboratory, biochemical, ultrasound, radiological, radioisotope, immunoenzymatic, and physical-chemical methods were used. Results. The pain was more intense in patients with urate nephrolithiasis than in patients with urate nephrolithiasis comorbid with metabolic syndrome. Manifestations of the inflammatory process increased in patients with urate nephrolithiasis comorbid with metabolic syndrome, and concomitant diseases intensified the excretion of stone-forming compounds. Metaphylaxis with quertin against the background of commonly accepted drugs that correct metabolic processes had a positive effect on the course of urate nephrolithiasis comorbid with metabolic syndrome and contributed to the reduction of stone formation relapse. Conclusions. In-depth diagnosis of metabolic processes can help the doctor to correctly determine the differentiated tactics of examination and treatment, as well as to prevent possible complications in a timely manner.