Introduction. Today, ultrasound examination (ultrasound), due to a number of advantages over other diagnostic methods (low cost, lack of ionizing radiation, the ability to perform without restrictions on age, gender, body weight, the presence of metal objects, etc.), is widely implemented in clinical practice. However, the accuracy in detecting urinary stones in the gray-scale mode varies from 33 to 95% and depends on the experience of the specialist performing the study and the quality of the ultrasound apparatus. One of the ways to increase the diagnostic accuracy of the method is to detect the twinkling artifact (ТA). However, data on its diagnostic accuracy in detecting urinary tract stones also vary (from 50% to 97%). The reason for this is the methodological features of the conducted scientific research, as well as the technical features of the ultrasound devices used in them, in some of which (devices 2000-2010) the ТA is programmatically turned off to improve vascular visualization. In some devices developed in the last decade, the possibility of obtaining AM has been returned. However, there are no methods for detecting ТA, optimal settings of the Doppler mapping mode for better visualization. In this regard, experimental work was carried out to develop a methodology for testing the ultrasound device in order to determine the possibility of using AM. Materials and methods. In 2023, the staff of the Lopatkin Research Institute of Urology and Interventional Radiology – a branch of the Federal State Budgetary Institution «NMIC of Radiology» of the Ministry of Health of the Russian Federation and the Bauman Institute conducted a series of experiments and developed a device (phantom) that allows AM to be studied in laboratory conditions. Ultrasonic devices were used to test the device during the development process: Philips Affinity 70 and ALOKA Ultrosound F75. To test the working properties of the device, an assessment was made of the possibility of obtaining AM on a number of ultrasonic scanners: BK Specto 5000, Simens, Samsung RS65, Samsung Rs 85, Mindrey Kesona, Hitachi Arienta 750. Fragments of urinary stones of various chemical compositions were used as the studied material. Results. A device has been developed, which is a plastic container 4*10*5 see, with a side wall thickness of 0.2 cm. A substrate made of platinum- based silicone is placed inside the device, the size of 10*5*2 cm. Along the central line of the substrate, at a distance of 2 cm from each other, there are 3 recesses for fixing the concretion, with a diameter of < 5 mm. To prevent the migration of the ultrasonic sensor during the study, a fixation system is provided in the form of 2 clamps located in the upper part of the container, connected to each other by means of a toothed connection. ТА was able to register in the area of all stones, including those artificially prepared from calcium sulfate dihydrate. The optimal settings of the color Doppler mapping mode have been determined for visualization. ТА was determined in all contact media, but the most accurate, corresponding to the contours of the concretion, was obtained using ultrasonic gel. Conclusion. The conducted experimental work on ТА visualization in laboratory conditions has shown that it is possible to obtain AM in vitro using the device developed by us. The developed device greatly simplifies the configuration of the Doppler mapping mode of the ultrasound device for better visualization of ТА and makes it easy to assess the possibility of using ТА on a specific ultrasound scanner.

Introduction. Urolithiasis is a serious medical, social and economic problem. Over the past decades the world has seen a progressive, approximately 3% per year, increase in its incidence. Urolithiasis occupies a leading position in the structure of urological diseases and has a high recurrence rate in the absence of metaphylaxis. In turn, the effectiveness of properly selected anti-relapse therapy has been proven by many studies and is about 50- 80%. The development of “tools” for rational metaphylaxis represents a potential “growth area” for improving the effectiveness of treatment for patients with urolithiasis. One of these tools is the correction of urine pH levels, since its violations are the most common. However, drugs used to correct pH levels have a number of limitations, which greatly complicates their use. One of the possible solutions to these shortcomings may be the creation of combined drugs that can comprehensively influence the factors that provoke the recurrence of stone formation such as the line of Litcontrol® Litura® products from Devicare (Spain). The purpose of this publication is the scientific rationale of the clinical effects of Litura® Up and Litura® Down in the metaphylaxis of urolithiasis. Materials and methods. A literature search and analysis of foreign and domestic literature was carried out from 1990 to 2024 with the selection of relevant publications in the еLibrary, PubMed databases and Google including keywords – the active components of Lit-Control® pH Up – potassium-magnesium citrate, theobromine, zinc, vitamin A, and Lit-Control® pH Down – phytates, L-methionine, zinc, vitamin A. References in included sources were reviewed to identify additional potentially relevant studies. 189 sources were found, based on the relevance of which 60 articles were selected. Results. The use of Litura® Up and Litura® Down has a scientific basis, and the included substances and their combination potentiate the clinical effect in the metaphylaxis of urolithiasis. However, controlled clinical studies are necessary to assess the prospects for using these complex agents. Conclusions. Based on foreign data from experimental and clinical studies, we can conclude that the Lit-Control® Litura® line of products used to correct urine pH levels and inhibit crystallization in various types of stone formation can be considered as a new promising approach to the metaphylaxis of urolithiasis.

Introduction. In the structure of urolithiasis, the predominant number of patients have stones consisting of calcium oxalate. These stones have a dense structure that is not amenable to litholysis and grows quickly. At the moment, there are no medications that can non-invasively relieve patients of this type of stones. In this connection, the main methods of treatment, depending on the size of the stones, are either lithokinetic therapy or surgical treatment. However, stone removal does not eliminate the cause of stone formation, and with this approach, relapse of the disease occurs within 5 years in 30-50% of patients. Today, the search for new approaches and means to reduce the risk of recurrence of calcium oxalate stones does not stop. One of these products is a representative of the Lit-Сontrol® Litura® line from Devicare (Spain) – Litura® Balance. The purpose of this publication is to theoretically substantiate the potential clinical effects of Litura® Balance in the metaphylaxis of calcium oxalate stones. Materials and methods. A literature search and analysis of foreign and domestic literature was carried out using the databases SCOPUS/ScienceDirect, PubMed/MEDLINE, eLibrary, Google Scholar, from 1990 to 2024 using keywords – the active components of Lit-Control® pH Balance – phytate, phytic acid, magnesium and polyphenols, vitamin A, zinc. References in included sources were reviewed to identify additional potentially relevant studies. 167 sources were found, based on relevance, of which 52 articles were selected. Results. The use of Litura® Balance has a scientific basis, and the included substances and their combination potentiate the clinical effect in the metaphylaxis of calcium oxalate stones. However, controlled clinical studies are necessary to assess the prospects for using these complex agents. Conclusions. The results of international experimental and clinical studies allow us to conclude that the complex product Litura® Balance, used to inhibit the processes of calcium oxalate crystallization and antioxidant protection of the urothelium, can be considered as a new promising approach to the metaphylaxis of calcium kidney stones.

Introduction. The study of lithogenic substances excretion in stone formers with pure monomineral stones allows us to identify characteristic metabolic changes, the long-term effect of which determines the originality of the pathogenetic mechanism features of the formation of urinary stones consisting of pure minerals. The problem of studying lithogenesis of «pure» (monomineral) stones in stone formers is of great clinical importance, since it assumes the existence of various approaches to prevention and metaphylaxis of urolithiasis in patients with «pure» stones and mixed stones. Materials and methods. We examined 982 patients with urolithiasis (439 men and 543 women aged from 18 to 79 years. Of these, 837 patients (384 men and 453 women) had «pure» urinary stones of various types, represented by one mineral. Metabolic parameters of excretion in patients were studied men and women with monomineral urinary stones of various chemical types. Results. In oxalate stones, the most active accumulation of the calcium oxalate mineral component and an increase in the number of «pure» oxalate stones by 1.25 times was observed in men than in women (p=0.046). Increased calcium excretion activates oxalate lithogenesis in men, as opposed to women, contributing to the accumulation of veddelite in pure oxalate stones. In contrast to women, the accumulation of calcium oxalate in stones in men is associated with increased excretion of uric acid, phosphates, and partly magnesium (p<0.01). In uric acid stones consisting of pure uric acid and uric acid dihydrate, pure uric acid stones were 1.52 times more common in women than in men (p<0.01), and did not depend on the level of uricosuria. Patients with pure uric acid stones had lower urine pH than patients with pure calcium-oxalate stones. The accumulation of uric acid in stones to the level of pure uric acid stones was accompanied in the groups of men by an increase in phosphaturia (p=0.021), and in the groups of women – with an increase in body mass index (p=0.028). Men with 100% uric acid stones had higher levels of excretion of calcium, uric acid and phosphates compared to female patients by 1.21 times, 1.3 times and 1.26 times, respectively (p<0.05). Urinary stones from pure carbonate apatite were rare in men and women. In women, stones of mixed composition with 80-90% carbonatapatite were more often detected, and in men with 60-70% of this mineral. In men, compared with women, with the accumulation of carbonatapatite in stones, an increase in the excretion of calcium, uric acid, phosphates and magnesium was observed (p<0.05). About 80% of mixed stones in stone formers men and women are pure calcium oxalate-phosphate bimineral stones consisting only of carbonate apatite and calcium oxalate. In men, in contrast to women, there was a predominance of calcium oxalate (1.24 times), the accumulation of which in these stones was higher. It is associated with increased excretion of calcium, uric acid, phosphates, and magnesium (1.41-fold, 1.32-fold, 1.35-fold, and 1.33-fold, respectively (p<0.05). Men with calcium oxalate-phosphate stones had higher calcium excretion than those with pure calcium oxalate or carbonate apatite stones and lower urine pH values than those with carbonate apatite stones (p<0.01). In women, level of calciuria did not play a big role in the genesis of pure calcium oxalate-phosphate, calcium oxalate and carbonate apatite stones. A more important factor in their lithogenesis was the alkaline reaction of urine, which led to the activation of carbonate apatite stone formation. Conclusion. The formation of urinary stone and the distribution of its mineral components depend on the interaction of various metabolic factors. The study of groups of patients with pure (100%) monomineral stones and patients with stones of mixed composition, in which main mineral is only the predominant part, allows us to identify characteristic complexes of lithogenic metabolic factors that distinguish these groups of patients from each other. This approach is important both for understanding the pathogenetic mechanisms of stone formation, and for choosing the directions of empirical therapy for urolithiasis and developing further metaphylactic measures that also take into account the gender of patients.

Introduction. We will try to show the place of acid-base balance (ABB) study in urolithiasis patients. There is the second article in a series of works devoted to the study of ABB in urolithiasis patients. This work is devoted to the study of the level of basic acid base indicators: blood pH, pCO2, pO2, BE. Materials and methods. The study was conducted prospectively at the N. Lopatkin Scientific Research Institute of Urology and Interventional Radiology – branch of the National Medical Research Radiological Center of the Ministry of Health of the Russian Federation. We analyzed data of 83 urolithiasis patients (39 men and 44 women). All patients underwent an analysis of the urinary stones chemical composition, biochemical analysis of blood and daily urine, blood acid-basic balance, blood parathyroid hormone. Urine pH morning was determined for all patients. Results. Patients with acidemia (blood pH <7.32) had significantly higher concentrations of chlorine, creatinine and ionized calcium in the blood than in the group of patients with 7.32 51 mmHg) than in patients with 41< pCO2 <51 mmHg. Patients with a BE level <-2.5 had significantly higher levels of creatinine, urea and chlorine in the blood, and higher urine pH (p<0.05) compared to patients with BE>2.5. Patients with BE < -2.5 also had significantly lower level of blood pH, pCO2 and ionized calcium compared to the group of patients with BE >2.5. Conclusion. Normalization of blood pH is capable to correct the metabolism of the main lithogenic substances in urolithiasis patients.

Introduction. Hyperuricosuria usually considered as the main metabolic factor in the formation of uric acid stones, but this issue remains unclear. Gender differences in the prevalence of urolithiasis (UL) indicate the need for a more detailed study of the lithogenic properties of uricosuria and its role in the development of various metabolic types of UL. In this study, was investigated the effect of varying degrees of uricosuria in men and women with UL on metabolic parameters and the frequency of detection of urinary stones of different chemical composition. Materials and methods. A total of 982 patientsа with UL (439 men and 543 women aged 18 to 79 years)were examined. To assess the lithogenic activity of uricosuria in men and women with UL, the values of uric acid excretion (in mmol/day) were ranked in ascending order and divided into 10 equal parts (ten 10%-х percentilesей). In each of the ranges, the percentage distribution of types of urinary stones and biochemical parameters of urine and blood were determined. Results. As the degree of uricosuria increased from minimum to maximum values in men and women, there were no differences in the percentage distribution of uric acid stones. The different orientation of the processes of urate lithogenesis is noted, which was manifested in uricosuria above 3.48 mM/day by the accumulation of anhydrous uric acid in the stones in women 1.47 times greater than in men, in whom the proportion of uric acid in the stones, on the contrary, decreased by 1.36 times. It was found that uricosuria above 3.48 mM/day was accompanied by activation of oxalate lithogenesis rather than uric acid: the incidence of oxalate stones in men increased by 1.55 times (p=0.0025), and in women by 2.16 times (p=0.0013). At the same time, the proportions of the oxalate component in the stones of male and female patients, respectively, increased, mainly due to the wevellite component. An increase in uric acid excretion over 3.48 mM/day led to a relative decrease in the frequency of detection of carbonatapatite stones in men by 1.85 times (p=0.0104), and in women by 2.0 times (p=0.0153). With increasing uricosuria, both men and women experienced an almost linear increase in the levels of calcium, phosphate, and magnesium excretion (p<0.0001). The blood phosphate content in women was on average 7-11. 6% higher than in men, and uric acid was lower by 8.5-16.0% for almost all values of uricosuria. Calcemia levels in men and women did not have statistically significant differences. for all values of uricosuria. Men in the age groups from 30-39yr to 60-79yr have a higher uric acid excretion than women, which also corresponds to a higher incidence of oxalate stones in men, exceeding this indicator in women in all age groups by 2.5 -1.8 times (p<0.05). The formation of uric acid stones is observed in men of an earlier age than in women, namely from the age of 18-29yr, while in women the formation of stones of this type is detected only from the age group of 40-49yr and older. Conclusion. Characteristic property of uricosuria of various degrees is its different ability to influence the dynamics of metabolic parameters of excretion and lithogenesis of calcium stones (oxalate and phosphate stones) in men and women in the absence of a noticeable effect on the lithogenesis of uric acid stones, which should be taken into account when conducting personalized metaphylaxis of urolithiasis.

Introduction. It is believed that Urolithiasis men of working age are most often affected. However, recent studies have shown that the difference between the incidence of this disease among men and women is rapidly decreasing due to the increased incidence of urolithiasis in women. The purpose of the study: to determine the prevalence of urolithiasis among women over 45 years of age as part of screening study in the Republic of Chuvashia. Materials and methods. A population study of 658 women over 45 years of age was conducted on the basis of hospital № 1 in Cheboksary (Republic of Chuvashia) in 2021-2022. All participants underwent ultrasound examination of the urinary system organs to detect urinary stones. The diagnosis was confirmed by CT of the abdominal cavity and retroperitoneal space. Statistical data processing was carried out using the Statistics 10,0 program and Microsoft Excel. Results. Of 658 women, 147 had previously noted urolithiasis in past, 124 of them were associated with this disease (the group with a positive history of urolithiasis), 511 had not previously sought medical help from a urologist for stones of the urinary system (the group with a negative history of urolithiasis). In total, 95 (14.4%) women with calculi in the urinary tract were identified. In the group with a positive history of urolithiasis, stones were detected in 22.4% of cases, with a negative one – in 12.1%. The most frequent localization of concretions in all groups was the lower group of calyx. The size of the concretions varied in the group with a negative history of urolithiasis from 5.70±0.77 mm to 7.50±0.50 mm, in the group with a positive history of urolithiasis – from 5.00±0.56 mm to 21.75±8.24 mm. Conclusion. The present study showed that the true incidence of urolithiasis is 14,4%, which is several times higher than the official figures. To study the true incidence of urolithiasis, it is necessary to conduct large epidemiological studies in the russian population.

Introduction. Chronic kidney disease (CKD) is a global medical problem. The long-term latent course of the disease leads to a progressive increase in its incidence. Along with laboratory methods of research in the arsenal of the diagnostic service, there are tools that allow you to detect a violation of the kidneys functional ability. Purpose. To analyze modern instrumental methods for diagnosing the functional ability of the kidneys. Materials and methods. The review was conducted based on data published in PubMed databases (https://www.ncbi.nlm.nih.gov/pubmed /) and еLibrary.ru (https://elibrary.ru) and was limited only to articles in scientific peer-reviewed journals. It was carried out until January 2023, by keywords: kidney ultrasound, computed tomography, positron emission tomography, magnetic resonance imaging, kidney function. Results. We found 189 sources not older than 10 years (published after 2012) that were relevant to the topic of the review. Conference abstracts, short messages, duplicate publications were excluded from them. After that, based on the relevance of the data, reliability of sources, impact factors of journals and the sequence of presentation of the material in the manuscript, 46 articles were selected directly for citation in the review. Also, when writing the review, original articles published before 2012 were used. Conclusion. The available modern instrumental methods for assessing renal function open up broad prospects for their clinical application and require further research.

Introduction. Distal renal tubular acidosis (dRTA) is a rare cause of stone formation in urolithiasis patients according to the conventional wisdom in the urological community. At the same time prevalence of the incomplete dRTA in patients with idiopathic calcium stones is 16.8% (13.6% in men and 25.5% in women) according to the recent studies. Previously, we published a review article, which describes the features of the dRTA etiology and pathogenesis, and presents diagnostic and treatment algorithms. We consider it interesting to present a clinical case in continuation of the previous publication. Clinical case. There are anamnesis data, results of laboratory and instrumental analysis of the patient Zh. with a urolithiasis and renal tubular acidosis are presented. The patient was prescribed a long course of conservative citrate and thiazide diuretics therapy. The patient managed to achieve normalization of the main parameters of blood and urine, stable remission of the disease against the background of ongoing therapy. Conclusions, patients with distal renal tubular acidosis and urolithiasis are quite common in the clinical practice of urologist. Timely diagnosis of the disease and the appointment of adequate therapy can improve the quality of patient's life and reduce the number of stone relapses.

ntroduction. Diagnosis and determination of treatment tactics in patients with urolithiasis are based on determining the causes of lithogenesis. At the moment, the standard of examination in patients at high risk of recurrence of urolithiasis is the detection of metabolic disorders based on the results of a biochemical analysis of blood and daily urine, as well as an assessment of the chemical composition of the urinary stone. The violations determined using this approach are a manifestation of the physico-chemical processes of stone formation, the assessment of which is currently practically not performed by urologists, due to the lack of simple diagnostic methods and tools. Materials and methods. The review was conducted on the basis of data published in PubMed databases (https://www.ncbi.nlm.nih.gov/pubmed) and Scientific Electronic Library еLibrary.ru (https://elibrary.ru/), and was limited only to articles in scientific peer-reviewed journals. The search was devoted to the study of the crystal-forming activity of urine, factors affecting the lithogenic properties of urine, as well as methods for assessing the risk of stone formation in the most common metabolic types of urolithiasis. We found 189 sources no older than 10 years (published after 2012) that were relevant to the topic of the review. Conference abstracts, short messages, duplicate publications wereexcluded from them. After that, based on the relevance of the data, reliability of sources, impact factors of journals and the sequence of presentation of the material in the manuscript, 41 articles were selected directly for citation in the review. Also, when writing the review, original articles published before 2012 were used. Results. The analyzed literature sources demonstrated a large number of methods for determining the crystallization properties of urine. However, none of them, in view of the complexity, as well as the ambiguity of the results obtained, have not been widely introduced into clinical practice. In view of this, it is required to develop a simple and informative method for diagnosing the crystal-forming properties of urine, which will increase the percentage of non-reactive urolithiasis. Conclusions. The methods available to doctors for determining the crystal-forming properties of urine are extremely laborious. The development of an easy-to-use and sufficiently accurate real-time determination of the crystallization and anti-crystallization properties of urine, will significantly improve the diagnosis, treatment and metaphylaxis of urolithiasis.

Introduction. Kidneys play a leading role in maintaining acid-base balance. Kidney disorders lead to the acid-base balance violations. Data analysis showed that there are not enough attention to the problem of assessing blood acid-base balance in patients with urolithiasis. The aim of the first stage of this work was to determine the presence and severity of changes in one of the main indicators of acid-base balance - the level of blood bicarbonate in patients with urolithiasis. Materials and methods. We analyzed data from 83 patients: 39 men and 44 women aged 18 to 74 years. All patients were prescribed a biochemical blood test, a biochemical analysis of daily urine, blood acid-base balance and stone chemical composition. We studied the relationship of actual serum bicarbonate (actHCO3 - ) and standard bicarbonate (stdHCO3- ) in urolithiasis patients with level of other blood and urine parameters. Statistical analysis was performed using the methods of descriptive statistics, comparative statistical analysis, calculation of the t-test for independent groups, correlation analysis for two variables using the computer program Statistica 10.0 (StatSoft USA). Results. According to the statistical analysis performed using the calculation of Student's t-test, patients with actual serum bicarbonate [actHCO3- ] <21.0 mmol/l and urine pH>5.8 had lower serum total calcium levels (p<0.05 ), higher serum [Cl-] (p<0.05), higher serum creatinine (p<0.05) and urea (p<0.05), lower serum pH (p<0, 05), serum pCO2 (p<0.05), serum lactate concentration (p<0.05), lower BE (p<0.05) than patients with [actHCO3- ] blood >28.0 mmol/l. Correlation analysis showed that there is a relationship between the level of [actHCO3- ] and indicators of total blood calcium (p <0.05), blood chloride (p<0.05), creatinine and blood urea (p <0.05) and the concentration of calcium and magnesium in the daily urine (p<0.05). There was no statistically confirmed relationship between the level of standard blood bicarbonate [stdHCO3- ] and the concentration of other indicators of blood and daily urine. Conclusion. Determination of the serum bicarbonate level is necessary to clarify the metabolic state in urolithiasis patients. It is necessary to determine the concentration of actual blood bicarbonate (actHCO3- ) in urolithiasis patients.

Introduction. Urine acidity is an important factor that can actively modulate the process of stone formation in the kidneys, which allows using this indicator to use this indicator to assess the risk urinary stone formation and control the result of anti-relapse treatment in patients with urolithiasis (UL). There are gender differences in the prevalence of UL, which may be related to differences in urine acidity. In this study, the effect of varying degrees of pH urine on metabolic parameters and the frequency of detection of urinary stones of various chemical compositions was studied in men and women with UL. Materials and methods. We examined 982 patients with ICD (439 men and 543 women aged 18 to 79 years). To assess the lithogenic activity of uricosuria in men and women with UL, the pH values of morning urine were distributed in ascending order and divided into several groups. In each of the ranges, the percentage distribution of types of urinary stones and biochemical parameters of urine and blood were determined. Results. At urine pH of 5.1-6.5, men have higher calciuria and are more prone to oxalate stone formation, which is 1.5-2.2 times more active in them than in women (p <0.05). In contrast to men, the urinary pH level of women had a greater effect on the frequency of detection of oxalate stones, which decreased by 75.9% with a urine pH of 5.5-5.9 and higher, and was accompanied by a 33.3% decrease in calciuria (p <0.05). Uric acid lithogenesis was more dependent on changes in the pH of urine than on the activity of urocosuria. The frequency of formation of uric acid stones was inversely correlated with the pH of urine in men (r=-0.833, p=0.0102) and women (r=-0.929, p=0.0009). With a decrease in the pH of urine below 6.0, the incidence of uric acid stones in women increased by 5.76 times (p<0.0001), and in men by 1.91 times (p=0.0087). Active phosphate lithogenesis in women did not depend on the level of phosphate excretion, which was 25.5-39.7% lower than in men and progressively decreased with increasing urine pH values (p<0.00029). When the urine pH is higher than 5.9, women have a significantly increased risk of developing calculi from carbonatapatite compared to men (p=0.0005). Struvite lithogenesis increased with urine alkalinization and was more pronounced in women than in men (p=0.043). Comparison of age groups did not reveal any differences in the acidity of morning urine between men and women, however, in contrast to men, a noticeable predominance of the proportion of women with carbonatapatite stones was observed in the groups of patients older than 49 years. Conclusion. Shifts in the pH of urine can change the nature and direction of lithogenesis in men and women in different ways and are not always associated with the excretion of certain metabolic factors involved in stone formation. Gender features of the lithogenesis of various types of stones in conditions of different acidity of urine should be taken into account when conducting personalized metaphylaxis of urolithiasis.

Introduction. Over the past decade, there has been a progressive increase in the number of patients with chronic kidney disease (CKD). Early diagnosis of renal insufficiency allows to prevent irreversible consequences leading to disability and significant medical and economic costs. Purpose: to analyze modern markers for determining the functional ability of the kidneys. Materials and methods. A search was carried out in PubMed and Library, according to the keywords creatinine, urea, glomerular filtration rate (GFR), clearance, formulas for calculating creatinine clearance, cystatin C, β2-microglobulin, β-bound protein, NGAL, KIM-1, chronic kidney disease, chronic renal failure, urolithiasis. We found 389 sources no older than 10 years (published after 2012) that were relevant to the topic of the review. 80 articles were selected directly for citation in the review. Results. GFR assessment and detection of albuminuria are the most effective methods, but biomarkers used to calculate GFR are subject to a number of factors and do not allow assessing kidney function in real time. For early prediction of acute renal injury, the most suitable biomarkers are considered to be: NGAL and KIM-1 and IL-18. Equations combining cystatin C and creatinine r work better than equations using only cystatin C or creatinine, especially in situations where it is necessary to confirm chronic kidney disease. The combination of creatinine, cystatin C and the ratio of urine albumin to creatinine improves the stratification of the risk of progression of kidney disease and mortality. The latest developments in biomarkers allow us to hope that in the near future the assessment of the functional ability of the kidneys will be carried out in real time and will become a general clinical practice of a modern doctor. Conclusion. Modern biomarkers of the functional ability of the kidneys allow not only to evaluate the function, but also to screen for diseases, conduct differential diagnosis, and evaluate the effectiveness of the treatment. The modern approach to the diagnosis of renal dysfunction should be based not only on its diagnosis, but also on determining the topic of nephron damage.

Introduction. Hypercalciuria is one of the main factors in the formation of the most common calcium-containing stones. Urolithiasis (UL) is more common in men than in women, which indicates the existence of gender lithogenic factors. In this work, the effect of varying degrees of calciuria in stone formers (men and women) on metabolic parameters and the frequency of detection of urinary stones of various chemical composition was investigated. Materials and methods. A total of 982 patients with UL (439 men and 543 women aged 18 to 79 years) were examined. To estimate lithogenic activity of calciuria in patients, the values of calcium excretion (mmol/day) were ranked in ascending order and divided into 10 equal parts (ten 10%-х percentilesей). In each of the calciuria ranges кальциурии, the percentage distribution of urinary stones types and biochemical blood and urine parameters were determined. Results. As the degree of calciuria increased from minimum to maximum values, the proportion of oxalate stones in men increased by 1.4-2 times, compared with women (χ2 test for trend p<0.02), and in women there was an increase in the proportion of carbonatapatite stones compared with men by 2-2.9 times (p<0.025, χ2 test). Increasing calciuria was accompanied by an increase in excretion, uric acid, phosphates and magnesium, which was more pronounced in men than in women (p<0.0001) and positively correlated in patients of both sexes with an increase in the frequency of detection of oxalate stones (p<0.05). The frequency of detection of carbonatapatite stones in men was directly dependent on calcium excretion (r=0.6783, p=0.0314). There was no such dependence in women, despite their high proportion of these stones, unlike men. Oxalate stones are more common in men in all age groups (20-70 years). In women, the greatest predominance of carbonatapatite stones is observed in the period from 20 to 40 years. Conclusion. Gender features of lithogenesis are clearly revealed at calciuria, which increases from minimum to maximum values. At the same time, the frequency of oxalate stones formation increases in men. Women have a high percentage of carbonatapatite stones, which, however, did not depend on the severity of calciuria. Thus, there are certain sex differences in lithogenesis of calcium stones and in dynamics of metabolic parameters of excretion, depending on the severity of calciuria, which can be used to assess the risk of stone formation and to implement a personalized approach to metaphylaxis of urolithiasis.

Recently, there has been a worldwide increase in the incidence of bladder cancer. Improved morphological diagnostics, increased surgical activity and availability of chemotherapy allowed reducing the one-year mortality rate and increasing the five-year survival rate. However, at the same time, there was a struggle with complications arising after the treatment. According to the world and domestic literature, it is noted that with an increase in life expectancy in patients who underwent radical cystectomy with intestinal urine derivation, an almost twofold increase in the frequency of complications, including the formation of urinary stones, is recorded. Previous studies have shown that about 60 % of the stones identified in this category of patients are infectious, and 40 % formed because of metabolic disorders, which have their own characteristics with different types of urine derivation. In this work, we present an overview of the predisposition for stone formation in patients who underwent cystectomy for musculoinvasive bladder cancer, taking into account the type of urine derivation.

Introduction. TUrolithiasis is a widespread disease. In 2019 year 889,891 cases of this disease detected in Russia, and the increase in morbidity since 2005 was 35.5%. The share of urolithiasis accounts for up to 50-60% of patients in urological hospitals, often hospitalized for emergency indications. At the same time, there are no specialized questionnaires aimed at identifying risk factors for urolithiasis. The purpose of the work: to study the use of questionnaires for the timely detection of urinary tract stones. Materials and methods. Based on the men's health cabinet of the City hospital No. 1» Cheboksary (Republic of Chuvashia) in 2020-2021, a survey of 700 men aged 40 to 80 years conducted. To form risk groups, a specially designed questionnaire used to identify stones of the urinary system. According to the sum of the Questionnaire scores, 2 groups of patients were formed: low risk (0-1 point) and high risk (2-8 points). To validate the Questionnaire, all respondents, regardless of the amount of points, underwent ultrasound of the kidneys and bladder, and patients with detected stones larger than 3 mm and MSCT. Statistical processing of the received material carried out using the computer program Statistics 10.0 and the Microsoft Excel application software package. Results. According to the sum of the Questionnaire scores, 2 groups of patients were formed: low risk (0-1 point) and high risk (2-8 points). Out of 700 respondents, 54 respondents with kidney stones identified: 11 in the low-risk group and 43 in the high-risk group. The total prevalence of urolithiasis in the studied population was 7.7%. With an increase for points, a progressive increase in the average size of concretions from 3.1 mm to 29 mm noted. The developed method of screening urolithiasis by means of a questionnaire has good indicators of sensitivity and specificity: 76.63% and 98.30%, respectively. Conclusion. Urolithiasis screening based on a combined approach using questionnaires and ultrasound can become a simple and affordable method for active detection of urolithiasis, formation and stratification of risk groups. Further research is required to objectify the data.

Introduction. Urolithiasis is a polyetiological, polypathognomonic metabolic disease characterized by the formation of kidney stones. The study of trends in the urolithiasis prevalence is of fundamental importance in practical medicine. The study of endemic territories allows us to analyze all possible risk factors for the development of urolithiasis from genetic to nutritional. The aim of our study is a comparative analysis of the urolithiasis prevalence in the Russian Federation for different periods. Materials and methods. We analyzed urolithiasis prevalence and incidence in the entire population of Russia from 2005 to 2020. The work is based on official statistics of the Ministry of Health of the Russian Federation. Statistical analysis of the data was carried out using the SPSS Statistics 21 software package. Results and discussion. Urolithiasis prevalence in the Russian Federation is considered in detail from 2005 to 2020. We did a comparative analysis of the data on the general urolithiasis prevalence, the incidence of urolithiasis, urolithiasis prevalence separately in the adult and children's population of Russia in the period from 2005 to 2020 out. We gave the leading regions in the Russian Federation in terms of the number of urolithiasis cases. We spent correlation analysis of the urolithiasis incidence with the number of cases of diabetes mellitus type 2, obesity and the level of meat consumption in the Russian population. Conclusion. Urolithiasis incidence and prevalence among the adult population is steadily growing in all regions of the Russian Federation, while the incidence among children remains stable. The relationship between the prevalence of urolithiasis and incidence of diabetes mellitus type 2 and obesity was noted.

Introduction. Some studies have shown that urolithiasis is much more common in the group of patients who underwent radical cystectomy (RC) with intestinal plastic bladder than the average for the population. The aim of this study included the search of the frequency of urinary stones formation in patients after RC, depending on the type of intestinal plasty of the bladder and the type of urinary diversion, the analysis of risk factors for lithogenesis, the search for metabolic lithogenic disorders in this category of patients, and the assessment of the severity of the identified changes. Materials and methods. The work analyzed the data of 214 patients (169 men and 45 women) who were operated from 2008 to 2021 with a diagnosis of bladder cancer. Patients underwent RC with the formation of a hetero- or orthotopic ileoconduit. We analyzed the indicators of general urine analysis, biochemical blood test, bacteriological analysis of urine for flora, performed both before RC and in the late postoperative period. Also The results of ultrasound of the kidneys, bladder (reservoir), MSCT of the kidneys performed before RC and in the late postoperative period were studied. We selected 37 patients from the general group in random order, who prospectively underwent a biochemical blood test, a biochemical analysis of daily urine, and an assessment of the acid-base composition of venous blood. Statistical analysis was performed by calculating the relative risk, as well as calculating the t-test for independent groups using the computer program Statistica 10.0 (StatSoft USA). Results. Urinary stones of the upper urinary tract after RC, ortho- and heterotopic intestinal plastics of the bladder in the late postoperative period (more than 1 year) were diagnosed in 27 out of 214 patients (12.6%). The relative risk of urolithiasis in patients with pyelectasis before surgery is 3.87 times higher than in patients without changes in pelvicalyceal system at the preoperative stage (p=0.0004). In patients after RC with impaired renal function in stages III-V (GFR 60 ml/min (p=0.005). RC patients with a BMI >30 had a 2.431-fold higher risk of urinary stone formation than those with a BMI 7.0, diagnosed after surgical treatment (p=0.003). The relative risk of developing urolithiasis in patients with urine pH >7.0 detected before surgery is 4.85 (p<0.0001). There was a trend towards an increase in the number of urolithiasis cases in patients who underwent RC with bacteriuria diagnosed after surgery according to urine culture (in patients with identified Enterococcus spp., Enterobacter cloacae, Providencia rettgeri (p<0.05)) compared with patients in of which sterile urine was detected. In patients suffering from urolithiasis after undergoing RC, compared with the control group of patients in the biochemical analysis of blood, there is a statistically significant difference between the level of creatinine (p=0.033), a decrease in the level of GFR from 79.9 to 68.7 (p=0.046). There was a statistically significant increase in the pH level of the urine (p=0.0025), an increase in the level of oxalates in the daily urine (p=0.0035), a decrease in the concentration of uric acid (p= 0.039), calcium (p=0.024) in urolithiasis patients after RCE compared with patients in the control group in biochemical analysis of daily urine. Conclusion. The presence of an expansion of the pelvicalyceal system before surgery, the patient's BMI> 30, urine pH> 7.0 both before and after the operation, a decrease in the patient's GFR <60 ml / min and the presence of bacteriuria in the general analysis of urine after RC are the risk factors for the urolithiasis after RC, intestinal plasty of the bladder.