ABSTRACT
An analysis was performed of results of treatment with extracorporeal shock-wave lithotripsy (ESWL) of 57 patients with coral-like nephrolithiasis (CLN), a total of 151 sessions. The policy of dealing with the patients has been worked out in conducting ESWL as related to the stage of formation, mineral composition of the coral-like calculus, functional condition of the kidneys, phase of the inflammatory process, condition of the urinary tracts, as well as to the indications for draining. Efficiency is shown of ESWL depending on the stage of formation of the coral-like calculus. An analysis of ESWL-related complications in CLN patients is submitted together with ways for their prevention and cure.
Subject(s)
Kidney Calculi/therapy , Lithotripsy , Humans , Treatment OutcomeABSTRACT
A study was made of urinary proteolysis. This parameter turned to be decreased in patients with nephrolithiasis versus normal subjects. The authors developed an original proteoclastic-ion theory of nephrolithiasis pathogenesis, based on the two main risk factors triggering the disease: low levels of urinary proteolysis leading to the formation of a calculous matrix; the urine pH values optimal for the sedimentation of lithiasic salts. The combination of both risk factors was responsible for the development of calculous crisis and the formation of microlith. The decreased index of urinary proteolysis calculated with the formula offered could be regarded as a risk indication to the microlith formation. A possible elimination of the both risk factors was demonstrated. The technique of microlithiasis metaphylaxis was developed with regard to the major and minor risk factors and the possibility of their elimination. The values of urinary proteolysis were the criteria for a successful therapeutic response. With regard to the number of risk factors the risk of primary nephrolithiasis or lithiasis relapses could be predicted.
