Introduction. Urolithiasis is a multifactorial recurrent disease, unevenly spread throughout the world and characterizedby the formation of urinary stones of various chemical compositions, depending on pathogenesis, etiological, and epidemiological risk factors. Understanding the composition of chemicals and their prevailing ratios can help make decisions about treatment tactics, preventive measures to reduce the risk of recurrence and the prevalence of urolithiasis.Purpose of the study. To assess the distribution of chemical components in urinary stones along with an analysis of their population significance.Materials and methods. The urinary stones were obtained from 2854 patients with urolithiasis. The composition of urinary stones was analyzed by using an infrared spectroscopy method.Results. The predominance of oxalate stones was determined in multicomponent kidney stones (83,7%) and the prevalence of urate stones (54,2%) was revealed in monocomponent kidney stones. Urinary stones with a predominance of oxalates contained significantly fewer impurities (12.4%) than urinary stones with a predominance of urates, phosphates and carbonates with an average amount of impurities >24.0%.Conclusion. The analysis of urinary stones distribution based on pathogenic factors showed that the calcium metabolism disturbances prevail in the population of the Russian Federation (88.0%).
The article presents the experience of treating patients with urolithiasis in the urological clinic of the Aleksandrovskaya hospital. Due to the improvement of technologies, the number of minimally invasive surgeries such as contact ureterolithotripsy, percutaneous nephrolithotripsy and percutaneous nephrolitholapaxy has increased significantly. Performing open surgical interventions is indicated only in complicated cases such as the presence of purulent calculous pyelonephritis. The indication for contact ureterolithotripsy is the localization of concretions in the pelvic ureter, as well as long-term (more than 4 weeks) presence of concretions in any part of the ureter. Percutaneous nephrolitolapaxy is the method of choice in the treatment of urolithiasis in case of uninfected kidney stones smaller and larger than 20 mm in diameter, especially in elderly patients. Emergency contact lithotripsy is indicated for treatment of acute serous obstructive pyelonephritis caused by concretion of any localization. When stones locate in lower calices of kidney effective method is percutaneous nephrolitholapaxy.
The aim of this study was to validate the method for analyzing the composition of calculus using infrared (IR) spectroscopy by studying model mixtures of salts. Study was made with an ALPHA-P IR Fourier spectrometer with OPUS software (Bruker, Germany). The samples of pure chemical salts manufactured by Sigma-Aldrich USA were used to validate the method. Salt mixtures were prepared in ratios of 10/90, 50/50 and 90/10. To assess the effect of the fraction size on the calculus component results, were used calculi of patients with urolithiasis. For each mixture were used 10 repeated measurements. Analysis of the composition of model salts showed that in the study of pure cystine salt CV(%) was 0,79%, calcium carbonate - 0,92%, sodium urate - 0,97%, calcium oxalate monohydrate - 4,94%, magnesium ammonium phosphate - 5,59%. And the most common components were analyzed in the composition of complex mixtures, including 90%, 50% and 10% of the investigated component. Calcium oxalate monohydrate has CV(%) 5.70% in mixture 9 part of it to one part of impurities, in mixture 50/50 - 21.57% and in 10/90 - 5.70%. For uric acid in 90/10 - 2.20%, in 50/50 - 10.09%, in 10/90 - 31.94%. For calcium carbonate in 90/10 - 9.02%, in 50/50 - 11.98%, in 10/90 - 24.70%. The dispersion analysis showed that the weighed portions of salts with a particle diameter of more than 0.8 mm provide reproducibility with a CV - 11.48%, with a diameter of 0.2-0.8 mm - 5.35%, and finally less than 0.1 mm - 2.28%. The accuracy of the method is high, but the reproducibility of the IR-spectroscopy method is relatively low in the analysis of stones of mixed composition, due to the greater error in the determination of impurities. Laboratories should pay special attention to optimizing sample preparation to ensure particle fineness less than 0.1 mm.
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