[Dissolution of uric acid stones in the ureter]. 2022

E A Frolova, and D G Tsarichenko, and V S Saenko, and L M Rapoport, and P V Glybochko
Institute of Urology and Reproductive Health, FGAOU VO I.M. Sechenov First Moscow State Medical University, Moscow, Russia.

BACKGROUND Uric acid stones (UA), consisting of uric acid/uric acid dihydrate, occur in 6.1-15.1% of all cases of urolithiasis in industrialized countries. At the same time, the frequency of these stones is directly dependent on age. Thus, the incidence of UA reaches 40% in men over 80 years of age and 27.3% in women over 90 years of age. UA are the only stones that are amenable to dissolution therapy with the use of citrate salts that alkalinize urine pH. A number of authors and European Association of Urology guidelines consider stone dissolution as a first-line therapy in the treatment of patients with UA, both as monotherapy and in combination with surgical procedures. METHODS The results of conservative treatment of 86 patients aged 28 to 78 years with radiolucent ureteral stones ranging in size from 3 to 25 mm and a density of 133 to 728 HU, who underwent 89 courses of stone dissolution therapy from 2011 to 2018, are presented in the article. They had no obstruction or were prestented. There were 52 men (n=55 courses) and 34 women (n=34 courses). RESULTS In 78 out of 89 clinical cases (87.6%), stone-free status was obtained within 14 to 181 days. Most often the duration of therapy was 30 days. In 11 (12.4%) cases the treatment was considered ineffective. However, only in 4 (4.5%) patients the stone size did not change, while in 7 (7.9%) cases it decreased. The results of the study suggest the high efficiency of citrate therapy in patients with ureteral stones in case of unobstructed urine outflow (including those with stents), which is comparable to surgical treatment.

UI MeSH Term Description Entries
D007669 Kidney Calculi Stones in the KIDNEY, usually formed in the urine-collecting area of the kidney (KIDNEY PELVIS). Their sizes vary and most contains CALCIUM OXALATE. Kidney Stones,Renal Calculi,Nephrolith,Renal Calculus,Calculi, Kidney,Calculi, Renal,Calculus, Kidney,Calculus, Renal,Kidney Calculus,Kidney Stone,Stone, Kidney,Stones, Kidney
D008297 Male Males
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000369 Aged, 80 and over Persons 80 years of age and older. Oldest Old
D012995 Solubility The ability of a substance to be dissolved, i.e. to form a solution with another substance. (From McGraw-Hill Dictionary of Scientific and Technical Terms, 6th ed) Solubilities
D014513 Ureter One of a pair of thick-walled tubes that transports urine from the KIDNEY PELVIS to the URINARY BLADDER. Ureters
D014514 Ureteral Calculi Stones in the URETER that are formed in the KIDNEY. They are rarely more than 5 mm in diameter for larger renal stones cannot enter ureters. They are often lodged at the ureteral narrowing and can cause excruciating renal colic. Ureteral Calculus,Calculi, Ureteral,Calculus, Ureteral
D014527 Uric Acid An oxidation product, via XANTHINE OXIDASE, of oxypurines such as XANTHINE and HYPOXANTHINE. It is the final oxidation product of purine catabolism in humans and primates, whereas in most other mammals URATE OXIDASE further oxidizes it to ALLANTOIN. 2,6,8-Trihydroxypurine,Ammonium Acid Urate,Monosodium Urate,Monosodium Urate Monohydrate,Potassium Urate,Sodium Acid Urate,Sodium Acid Urate Monohydrate,Sodium Urate,Sodium Urate Monohydrate,Trioxopurine,Urate,Acid Urate, Ammonium,Acid Urate, Sodium,Acid, Uric,Monohydrate, Monosodium Urate,Monohydrate, Sodium Urate,Urate Monohydrate, Monosodium,Urate Monohydrate, Sodium,Urate, Ammonium Acid,Urate, Monosodium,Urate, Potassium,Urate, Sodium,Urate, Sodium Acid
D052878 Urolithiasis Formation of stones in any part of the URINARY TRACT, usually in the KIDNEY; URINARY BLADDER; or the URETER. Urinary Lithiasis,Lithiasis, Urinary

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