Introduction. Literature data and our own research indicate that therapy with immature cell secretion products (secretome) has a pronounced nephroprotective effect both in acute kidney injury and in chronic renal failure (CRF). Considering that the source of the complex of signaling molecules stimulating reparative processes in organs are low-differentiated cells of functionally and anatomically immature organs in a state of deveopment, the question arises to what extent tissue transplantation of these organs reproduces the effect of therapy with a secretome of stem cells in relation to the progression of CRF. Material and methods. The experiments were carried out on 40 outbred male rats weighing 260-290 g, in which CRF was modeled by resection of 4/5 functionally active renal parenchyma. In the 1st series (control), no therapeutic actions were performed. In the 2nd series, after modeling CRF, a course of therapy with Cellex, the active component of which is the secretome of pig embryonic brain cells, was carried out in the form of 2 10-day courses with a 10-day break between them. In the 3rd and 4th series, immediately after CRF modeling, kidney or testicle tissue obtained from newborn baby rats (1-2 days after birth) was injected under the capsule of the resected kidney as a source of immature cells. Tissues of different organs were used to assess the severity of the tissue-specific effect of therapy. Results. 7 days after the modeling of CRF in all series, a deterioration of more than 2 times of all functional parameters was revealed. After 1 month, in the control and in the 2nd and 3rd series, a tendency to an increase in GFR was revealed, which did not reach statistical significance, whereas in the 4th series, the increase in GFR turned out to be statistically significant. After 2 months in the control series, there was a repeated decrease in the GFR index, whereas in all experimental series, GFR continued to increase or remained at subnormal values. The activity of tubular reabsorption of sodium and calcium after a significant decrease after 7 days to 1 month in the control series increased slightly (but unreliably), and after 2 months they again decreased to values 2 times lower than normal. In all experimental series, after 1 and 2 months, the reabsorption of these electrolytes was at values close to normal. The improvement was especially pronounced in groups 2 and 4. After 7 days, the activity of intracellular enzymes (aspartate aminotransferase (AST), alkaline phosphatase (ALP), lactate dehydrogenase (LDH)) in the blood increased in all series with a gradual decrease in hyperfermentemia after 2 months, more pronounced in group 4, as well as in all experimental groups with respect to LDH. Histological examination of the condition of neonatal transplants revealed the destruction of transplanted kidney tissue and a viable testicular graft. Conclusion. Transplantation of neonatal organ tissue under a kidney capsule to rats with CRF has a comparable nephroprotective effect with therapy with the secretome of embryonic cells (Cellex drug). A more pronounced improvement in functional parameters during testicular tissue transplantation is explained by the preservation of the viability of the graft.

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. 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.

Introduction. It is believed that the «target» of the hexane extract of Serenoa repens (HESR) is the prostate gland itself. However, there is evidence in the literature that the therapeutic effect of HESR can be carried out at the level of the bladder. We hypothesized about the direct effect of HESR on the obstructive bladder, preventing the development of its dysfunction. Material and methods. The study was conducted on 30 white mongrel female rats. Bladder outlet obstruction (BOO) was modeled by applying a ligature to the urethra on 18G catheter. The animals were divided into groups: experimental – HESR (n = 10); sham/placebo (n = 15) and control (n = 5). From the day following the operation, rats of the experimental series daily received aqueous alcohol suspension of HESR (27.6 mg/kg) intragastrically through a probe, and the sham group received the same volume of 3.5% alcohol solution. After 2 weeks, the survival rate of the animals, the functional state of the bladder, daily diuresis, biochemical changes in blood and urine characterizing the functional state of the kidneys were evaluated. Bladder function was assessed according to infusion cystometry. After examination, the animals were euthanized and the bladders was removed to determine its mass and histological examination. Results. Within 2 weeks in the sham group 10 (67%) rats died due to renal failure, while in the HESR group – only 3 (30%). An obvious overfilling of the bladder in the main and sham groups was revealed. Bladder volume was larger in the HESR group compared to the sham (p<0.05) one. The daily diuresis of the animals of the main group was also higher compared to the sham group, and the decrease in diuresis in the sham group was lower compared to the control (p=0.045). The functional state of the bladder was assessed by filling cystometry. In the sham group, an increase in intravesical pressure occurred immediately after the start of fluid infusion and its growth was accompanied by irregular fluctuations, which is a manifestation of secondary detrusor hyperactivity, while in the HESR group, a gradual increase in pressure without fluctuations up to large volumes of fluid was observed. The dynamics of the volume/pressure index in the main group was close to normal, which indicates better compliance of the wall of the hypertrophied bladder during HESR therapy. The use of HESR contributed to better preservation of kidney function. In terms of daily diuresis, glomerular filtration rate, tubular reabsorption of sodium, daily excretion of urea and creatinine in the urine, statistically significant differences were established between the main and sham groups. In the sham group, a more pronounced activity of creatine phosphokinase was noted compared to the HESR group (p<0.05), which indicates a significant damage to kidney and bladder cells (cytolysis) during BOO. Animals of both groups showed pronounced detrusor hypertrophy. If in the sham group the mass of the bladder exceeded the average value of the control group by 5.7 times, then in the HESR group it was 10.5 times. Histological studies confirmed the development of bladder hypertrophy, which was statistically significantly more pronounced in the HESR group: an increase in the thickness of the detrusor (p<0.001) and bladder wall (p<0.05). At the same time, the area of perimuscular sclerosis foci was significantly larger in the sham group (p<0.05), which indicates bladder decompensation. Thickening of the bladder wall also occurred due to the submucosal layer, which was more noticeable in the sham series (p<0.05) and was associated with the presence of edema, inflammatory infiltrates, and sclerosis in this area. In half of the cases of the sham series, de-epithelialized areas of the bladder mucosa were observed, while in the HESR group they were absent. In the experimental series, in all samples, a pronounced expansion of the vessels of the submucosal layer was noted. At the same time, if in the experimental group inflammatory infiltration was detected only within the submucosal layer, then in half of the cases of the sham series, diffuse infiltration of the entire bladder wall was detected. Conclusion. In BOO detrusor hypertrophy, the use of HESR contributes to the better preservation of the functional parameters of the bladder (compliance and evacuation ability), reduces the degree of inflammation and sclerosis of the bladder wall, prevents the development of decompensation of the bladder and, thereby, contributes to the preservation of kidney function. A significant decrease in the frequency of development and the degree of detrusor hyperactivity against HESR makes it possible to think about it’s direct effect on the smooth muscle cells of the bladder wall and/or on the way of regulating their contractile activity. The mechanisms of the HESR effects on the BOO bladder are currently unclear. This is probably of a complex nature, where the anti-inflammatory effects of Serenoa Repens are expected to play a primary role.

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. 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.

Introduction. In previously published experimental studies, we have shown that in rats with pre-modeled acute post-ischemic renal failure, therapy with a proteomic complex isolated from brain cells of pig embryos has a pronounced therapeutic effect, reducing the severity of functional and histological disorders and preventing the transition of the pathological process into chronic kidney insuffiency. The aim of this study is to evaluate the effectiveness of this therapy for the course of artificially induced chronic renal failure (CRF) in rats. Material and methods. Experiments were carried out on 45 white mongrel male rats weighing 200-240 g. CRF was modeled by unilateral nephrectomy and resection of both poles of the remaining kidney, which reduced the mass of the functioning parenchyma by 80%. In the 1-st series of experiments no therapy was performed. In the 2-nd - 4-th series the animals were intraperitoneally injected with a fractionated xenogenic proteomic complex (secretom) from pig brain stem and progenitor cells (SSPC) at a daily dose of 0.1 ml in different modes: two 10-days courses with a 10-days break between them (2nd series); prolongation of the 1st course up to 20 days and a repeated 10-days course after 10 days (3rd series); continuous SSPC therapy for 30 days (4-th series). 5th series – intact animals. The effectiveness of therapy was evaluated based on the severity of the development of compensatory renal hypertrophy, the dynamics of biochemical parameters of kidney function, the activity of enzymes (ALT, AST, LDH, alkaline phosphatase) in blood and urine and the level of uremic neurotoxins 3-indoxyl sulfate and ptolyl sulfate in the blood. Results. SSPC therapy in all variants contributed to a more pronounced compensatory hypertrophy of the remaining kidney, as well as a decrease in the severity of the main functional indicators after 30 and 60 days: the severity of polyuria decreased, the concentration of urea in the blood decreased to a greater extent, and the glomerular filtration rate and tubular reabsorption of sodium and calcium approached normal values, which was not observed in the control series. The severity of the therapeutic effect was more pronounced with continuous 30-day therapy. There was also a less pronounced increase in the activity of enzymes in the blood and their excretion in the urine, which indicated the cytoprotective effect of SSPC therapy. If in the control series of experiments, the deterioration of the studied indicators were noted with an increase in the observation period from 30 to 60 days, whereas in all experimental series they remained at a subnormal level. SSPC therapy also contributed to a lower accumulation of uremic toxins (3-indoxyl sulfate and p-tolyl sulfate) in the blood. Conclusion. Prolonged therapy of SSPC prevents the progression of CRF by stimulating compensatory hypertrophy of the kidney and cytoprotective effect and promotes more effective elimination of uremic toxins, preventing their accumulation in the blood.

Introduction. The lithogenesis causes study is extremely important for the surgical treatment tactics determining and for urolithiasis metaphylaxis. Materials and methods. It was used data published in the PubMed databases, the scientific electronic library eLibrary.ru, and on the website of the European Association of Urology. Results. According to modern concepts of the lithogenesis, urolithiasis is a polyetiological and polypathognomonic disease. Renal tubular acidosis (RTA) is the most studied tubulopathy leading to stone formation. Present literature review introduce genetic mutations, describes diseases and conditions leading to urolithiasis and RTA. We have given in detail the features of the urolithiasis course in RTA patients. Methods for RTA diagnosing, features of drug therapy and urolithiasis metaphylaxis in RTA patients, and criteria for evaluating the effectiveness of therapy are in a special place in the review. Conclusion. It is important for a practicing urologist to remember that distal RCA may be one of the causes of lithogenesis in patients with recurrent urolithiasis. The main diagnostic criteria are specific changes in the parameters of the biochemical analysis of blood, daily urine, as well as specific indicators of urine pH.

Introduction. The role of the organic matrix in urinary stones genesis in urolithiasis patients is still unclear. The presence of a large amount of protein in the urinary stones matrix suggests the participation of the protein matrix in lithogenesis. Research of the amino acids spectrum in urine is of great interest so far as amino acids are the part of the matrix proteins of the urinary stone. Material and methods. We analyzed urinary excretion of the following amino acids and low molecular weight compounds: tryptophan, lysine, trimethyllysine, sarcosine, choline and 4-pyridoxine acid. We used ultra-performance liquid chromatography in combination with a TQD mass spectrometer. Results. A higher level of excretion of choline and sarcosine is typical for patients with oxalate stones, compared with healthy people. Uric acid stone patients have high concentration of choline and extremely increased concentration of trimethyllysine in the urine unlike healthy individuals. Very low concentration of trimethyllysine, choline, sarcosine and higher excretion of tryptophan are specific for oxalate urolithiasis, in contrast to urate stone patients. Conclusion. The intensity of amino acids and low molecular weight compounds urinary excretion has characteristic features in patients with various types of urolithiasis and healthy individuals. Indicators of excretion of these amino acids and low molecular weight substances can serve as criteria for the activity of oxalate or urate lithogenesis along with the known metabolic lithogenic factors of urine. We can use it as additional target indicators to assess the success of anti-relapse treatment.

Introduction. Low adherence treatment is one of the reasons for the failure of the treatment of chronic diseases, including urolithiasis. The main efforts to increase patients' adherence to treatment should be aimed at acquiring knowledge about possible complications and prognosis of the course of the disease, as well as about the main methods of diagnosis and treatment. However, there is currently no tool to comprehensively assess the initial level of knowledge in these matters and thereby determine the level of adherence to the treatment of urolithiasis. Materials and methods. On the basis of N. Lopatkin Sciantific Research Institute of Urology and Interventional Radiology conducted a study to study the adherence of patients to the metaphylaxis of urolithiasis. The study involved 183 patients (78 men and 105 women). The mean age of the participants was 50.39±0.96 years. The study was conducted on the basis of data obtained using a specially designed questionnaire that allows determining risk factors for the development of urolithiasis, patients' knowledge of anti-relapse treatment of urolithiasis and their readiness for metaphylaxis of urolithiasis. Statistical data processing was carried out using computer programs Statistica 10.0 (StatSoft, USA) and MedCac 13.0 (USA) using parametric methods: descriptive statistics, chi-square and chi-square for the trend. Results. Women are the most informed in matters of urolirthisis metaphylaxis. However, only 15.8% of patients with urolithiasis, regardless of gender, know nutritional recommendations to reduce the risk of recurrence of stone formation. 67.2% of the respondents lacked knowledge about the pH and density of urine, as well as the importance of their control and correction. Almost all participants in the study noted their willingness to change their lifestyle to prevent recurrence of stone formation. however, women attach more importance to the metaphylaxis of kidney stone desease. Conclusions. Assessment of adherence to KSD metaphylaxis is an important component in reducing the frequency of stone formation recurrence, improving the prognosis of the course of the disease, as well as improving the quality of life of patients. the observed lack of patient knowledge of risk factors requires increased health education. The development and implementation in practice of a personal approach to metaphylaxis, taking into account the factors we have discovered, can improve adherence to the treatment of urolithiasis.

Introduction. It has been established that prolonged androgen-deprivation therapy (ADT) of prostate cancer leads to a decrease in bone mineral density (BMD) and increases the risk of fractures, which is an important medical and social problem. Zoledronic acid (ZA) is most often used for the prevention of osteoporosis against the background of ADT. The purpose of the study is to determine the efficacy and safety of ZA for the treatment and prevention of osteopo-rosis in non-metastatic prostate cancer against the background of ADT therapy with GnRH agonists. Materials and methods. The study included 45 men aged 54-81 years with morphologically verified prostate cancer (stages T2-4 N0-1 M0) who underwent surgical castration at least 6 months before inclusion or continuously received therapy with GnRH agonists. The blood level of CTX-1 was used as the main marker of bone resorption. To assess the BMD, the screening method of dual-band X-ray densitometry of the calcaneus with laser determination of the examination area – DXL using the CALSCAN apparatus and the DXL Calscan Workstation software was used. Patients were randomized into groups of 15 people each: Group 1 – received intravenous infusion of ZA at a dose of 4 mg at the beginning of the study and after 3 months of treatment; Group 2 received ZA at 2 mg in the same mode; Group 3 – control. For antire-sorptive therapy (ART), the drug Resorba (JSC «Pharm-Synthesis», Russia) was used. The duration of follow-up was 6 months. Results. In 13 out of 15 patients of Group 1, 3 months after the first administration of ZA, a decrease in the level of CTX-1 by 50% or more was observed, and after 6 months all 15 patients (100%) reached the age norm («complete answer»). Group 2 patients also responded to ART and by the 6th month 13 out of 15 (87%) had achieved a «complete response». In the control group by the 6th month the decrease in CTX-1 was not observed in any of the patients. Initially, the values of BMD in the studied groups did not differ. By the 3rd month of the study, the BMD index significantly increased only in Group 1. In Group 2 this indicator significantly increased by the 6th month of treatment. At the same time, in Group 1 after 6 months the BMD index reached higher values than in Group 2: an increase of 27% and 13%, respectively. In the control group, by the 6th month of observation, a significant decrease in BMD by 12% was noted. In Group 1, the number of patients with osteoporosis decreased to 6% and with a normal level of BMD – reached to 40%. Conclusion. High efficacy and sufficient safety of ZA in doses of 4 mg and 2 mg i/v one time in 3 months for anti-resorptive therapy in patients receiving long-term hormonal therapy with GnRH agonists has been demonstrated.

Introduction. The development of oxidative stress and nonspecific inflammation is one of the leading factors in the development of benign prostatic hyperplasia (BPH) and associated urination disorders in metabolic syndrome (MS). However, the specific mechanisms of these processes are not entirely clear. The purpose of the study. To study the activity of reactive oxygen species production and the functional state of mitochondria in the prostate and bladder and their role in the dysfunction of these organs using an experimental model of MS induction in rats. Material and methods. In 10 adult mongrel male rats MS was induced by keeping them on a high-calorie diet with an increased content of carbohydrates and fats for 3 months. 10 rats kept on a standard vivarium diet served as controls. The development of MS was confirmed by characteristic changes in the biochemical analysis of blood (hyperglycemia, hyperuricemia, dyslipidemia, hyperinsulinemia). In both series of rats, sections of the native prostate and bladder were examined by laser confocal microscopy and stained with fluorescent probes that characterize the activity of the production of reactive oxygen species (dichlorofluorescein-DCF) and the functional state of the mitochondria (tetramethylrodamine ether – TMRE). The activity of a number of intracellular enzymes (AST, ALT. Alkaline phosphatase, LDH) was investigated in the tissues and urine. Results. In rats with MS, the development of BPH and hypertrophy of the bladder were revealed, confirmed histologically. The study of sections of both organs by confocal microscopy revealed a significant increase in the production of reactive oxygen species by their cells and a decrease in the functional activity of mitochondria, which indicated the development of oxidant stress and tissue hypoxia. In the prostate, this was accompanied by a decrease in the secretory activity of the prostate glands, and in the bladder – the release of cytoplasmic enzymes from damaged cells into the urine, indicating cell damage. Conclusion. The causes of the development of a non-specific inflammatory process in the prostate and bladder, leading to dysfunction of these organs in MS, are increased production of reactive oxygen species and the development of tissue hypoxia.

INTRODUCTION:Dietary supplements are successfully used in many fields of medicine, including urology. In particular, urologists often prescribe dietary supplements for patients with urolithiasis.AIM:to study an influence of dietary supplements Nefradoz on the metabolism of the main stone-forming substances and inhibitors of stone formation in patients with urolithiasis.INTRODUCTION:Dietary supplements are successfully used in many fields of medicine, including urology. In particular, urologists often prescribe dietary supplements for patients with urolithiasis.AIM:to study an influence of dietary supplements Nefradoz on the metabolism of the main stone-forming substances and inhibitors of stone formation in patients with urolithiasis.MATERIALS AND METHODS:A total of 60 patients with urinary stone diseases were included in a single-center prospective randomized study. All patients were divided into 2 groups of 30 people, depending on the treatment. In the main group, patients followed standard diet, received general recommendations and dietary supplements Nefradoz for 28-30 days, 1 capsule (150 mg) 2 times a day with meals. In the control group, patients received only general recommendations and followed standard diet therapy for 28-30 days. The blood biochemical profile and 24-hour urine analysis were evaluated, as well as a urinalysis was performed on daily basis.RESULTS:In patients receiving Nefradoz, urinary uric acid excretion increased by 0.9 mmol/day. It must be emphasized that an increase in uric acid excretion did not exceed the upper normal limit. A tendency towards an increase in urine excretion of sodium (by 54 mmol / day), magnesium (by 1 mmol / day) and citrates (by 0.6 mmol / day) was also found. The analysis of urinalysis showed that in the main group, urine specific gravity was lower than in the control group. Higher urine pH in the main group compared to the control group was also shown. The severity of hematuria with the use of Nefradoz was almost two times lower than in patients who did not receive dietary supplement.CONCLUSION:Considering our data on the ability of dietary supplement Nefradoz to increase the concentration of main inhibitors of stone formation (magnesium and citrates), Nefradoz can be recommended for patients with urinary stone diseases, especially with concomitant hypomagnesuria and hypocitraturia.