medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2015-4-92-95medsovet-161Research ArticleУРОЛОГИЯUROLOGYКонсервативная терапия уратного литиаза. Обзор литературыConservative therapy of uric acid lithiasis: a review of literatureМалхасянВ. А.MalkhasyanV. A.noemail@neicon.ruСеменякинИ. В.SemenyakinI. V.noemail@neicon.ruИвановВ. Ю.IvanovV. Y.noemail@neicon.ruПоповаА. С.PopovaA. S.noemail@neicon.ruМосковский государственный медико-стоматологический университетРоссияMoscow State University of Medicine and DentistryRussian Federation201530122015049295Copyright © Малхасян В.А., Семенякин И.В., Иванов В.Ю., Попова А.С., 20152015Малхасян В.А., Семенякин И.В., Иванов В.Ю., Попова А.С.Malkhasyan V.A., Semenyakin I.V., Ivanov V.Y., Popova A.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/161

Мочекаменная болезнь (МКБ) продолжает занимать важное место в повседневной практике уролога и практикующих врачей общего профиля. Уратный нефролитиаз, по разным данным, составляет около 20% всех случаев мочекаменной болезни. К факторам риска уратного нефролитиаза относят гиперури-кемию, гиперурикозурию, низкий объем и рН мочи. Для устранения основного фактора риска МКБ - сниженного рН мочи - используют различные цитратные препараты. Цитратные смеси представляют собой соли сильных оснований в сочетании со слабыми кислотами, которые подщелачивают (нейтрализуют) рН мочи, при этом компонент кислоты метаболизируется. При выявлении у пациентов гиперурикемии, образование мочевой кислоты можно снизить путем применения ингибиторов ксантиноксидазы, механизм действия которых заключается в угнетении ксантиноксидазы - фермента, катализирующего превращение гипоксантина в ксантин и ксантина в мочевую кислоту, являющуюся конечным продуктом пуринового обмена у человека. Литературные данные подтверждают эффективность применения цитратных смесей и ингибиторов ксантиноксидазы для лечения больных с уратным нефролитиазом.

Urolithiasis (UL) continues to play an important role in the daily practice of urologists and general practitioners. According to various sources, uric acid nephrolithiasis accounts for about 20% of all cases of urolithiasis. Risk factors for uric acid nephrolithiasis include hyperuricemia, hyperuricosuria, decreased urine output and low urine pH. The major risk factor for UL, low urine pH, is managed by different citrate drugs. Citrate mixtures are strong base salts combined with weak acids which alkalize (neutralize) urine pH, whereas the acid component is metabolised. In patients diagnosed with hyperuricemia, uric acid production can be reduced with the help of xanthine oxidase inhibitors which act as suppressors of xanthine oxidase - an enzyme that catalyzes the oxidation of hypoxanthine to xanthine and xanthine to uric acid which is the end-product of purine metabolism in humans. The medical literature confirms the efficacy of citrate mixtures and xanthine oxidase inhibitors for the treatment of patients with uric acid nephrolithiasis.

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The authors declare that there are no conflicts of interest present.