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Статья нашей кафедры с 23-го Всемирного Конгресса Эндоурологии

The Possibility to Contribute on Diuresis and Calciuria in Idiopathic Calcium Urolithiasis.

A.A. Gaybullaev , S.S. Kariev, B.Sh.Tursunov

Department of Urology, Institute of Postgraduate Medical Education,

Tashkent , Republic of Uzbekistan (centre2@uzsci.net).

Introduction: Ordinary high fluid intake alone in hot climate does not allow to achieve desirable increase in diuresis due to excessive sweating. For this it is necessary to introduce the infusions of herbal diuretics (IHD) in the methaphylactic complex. It is particularly important in calcium urolithiasis. In view of the various steps considered important or possibly contributing to the development of methods aimed at increase a diuresis, as well as correct a calciuria in idiopathic calcium urolithiasis (ICUL), are to be valuable and actual.

Purpose: To study a possibility of IHD to contribute to diuresis and calciuria in patients with ICUL.

Materials and Methods: 275 calcium stone formers were divided in groups according to the type of infusion taken: Alhagi pseudoalhagi (AP), Aerva Lanata (AL), Zea Mays (ZM), Achillea filipenduluna (AF), Glycyrrhiza glabra (GG), Zizifora Copitata (ZC), Hypericum perforatum (HP), Helichrysum marocandicum (HM), Oryganum tyttanthum (OT), Bidens Tripartita (BT), Mentha piperita (MP). They were prescribed at a dose of 0,8 ml/kg of body weight 3 times a day for 2 months. Diuresis and calciuria have been observed.

Results: Strong diuretics (>50%): AL = diuresis +61,6% / calciuria -68,4%*; AP = +56,4% / -22,8%*; GG = +54,4% / -38,8%*.

Moderate diuretics (25-50%): ZM = +47,5% / -25,7%*; AF = +42,5% / -13,9%*; ZC = +30,8% /-27,5%*.

Delicate diuretics (<25%): MP = +24,4% / -9,3%; HP = +14% / +4,9%; HM = +12% / -3,3%; BT = +11,6% / +1,7%; OT = +6,9% / +0,3%.

(* - р <0,05; data observed demonstrate percentage difference in index relatively to initial meaning).

Statistically significant decrease of calciuria has been observed in patients taking strong and moderate diuretics. However, the degree of hypocalciuric effect was different. While diuretical effect of strong diuretics did not statistically differ, their influence on calciuria had statistically significant difference. It should be noted, that moderate diuretics - ZM, ZC showed more significant hypocalciuric effect as compared with a strong diuretic - AP. The delicate diuretics showed non-significant hypocalciuric effect, and HP, BT could even increase of calciuria.

Conclusions : Although decrease of calciuria is in direct proportion to increased diuresis, it is not yet excluded existence of different hypocalciuric mechanism, which could explain difference in activity in groups as well of strong, as moderate diuretics too. Purposeful use of IHD, able to change not only diuresis, but calciuria as well, supposes improvement in results of methaphylactic treatment in patients with ICUL.