NEPHROPROTECTIVE AND LITHOKINETIC THERAPY IN PATIENTS WITH UROLITHIASIS UNDERGOING RETROGRADE PYELOLITHOTRIPSY

In the context of modern medical development, when endoscopic approaches to the treatment of urolithiasis are actively being implemented, therapeutic strategies aimed at evacuating small stones and their fragments from the kidneys and upper urinary tract, as well as nephroprotective measures, are gaining new relevance. The use of herbal preparations with pronounced urolithic and nephroprotective properties is quite promising for the therapy of urolithiasis due to their high efficacy and safety. One of the representatives of this group of drugs is Nephrobiolic. Objective.Evaluation of the efficacy and safety of the Nephrobiolic complex as a lithokinetic and nephroprotective therapy in patients after retrograde pyelolithotripsy. Materials and Methods. The study included 30 patients with stone localization in the renal collecting system. By the method of typological selection, the patients were divided into 2 groups of 15 people each, comparable in age, stone size, and clinical data. All study participants underwent Multislice Computed Tomography (MSCT) of the kidneys with recording of the size, contour of the stone, and its density. The size of the stone did not exceed 10 mm in diameter. The density of the stones ranged from 600 to 1500 HU. All patients underwent scheduled kidney stenting on the affected side 10-12 days prior. As part of inpatient treatment, they underwent laser retrograde pyelolithotripsy. Before the surgery, two days after the surgery, and thirty days after the surgery, all patients underwent the necessary examination. As postoperative therapy, patients received drugs of the following classes: nonsteroidal anti-inflammatory drugs (NSAIDs), uroseptics, antispasmodics, dietary therapy, and, if necessary, antibacterial therapy. Patients in group 2 additionally received Nephrobiolic at 2 capsules 2 times a day for 1 month (5–7 days before surgery + 23–25 days after surgical treatment (pieholithotripsy)), with subsequent follow-up observation for 1 month. Results. The passage of stone fragments after retrograde intrarenal surgery (RIRS) was more effectively observed in the group receiving Nephrobiolic. When assessing the level of urine enzymes (alkaline phosphatase (ALP), lactate dehydrogenase (LDH), gamma-glutamyltransferase (GGT), and leucine aminopeptidase (LAP)) in all patients after lithotripsy, an increase in enzymeuria was noted in both groups, more pronounced in group 1, indicating damage to the kidney cell membranes due to the surgical intervention. When assessing the level of enzymuria in the remote period, in the 2nd group of patients this indicator returned to baseline (pre-intervention) values, in the 1st group – a moderate increase in the level of enzymuria persisted. Conclusion. Nephrobiolic promotes a more effective and less painful expulsion of stone fragments after retrograde pyelolithotripsy. This phytocomplex is capable of protecting kidney tissue from the damaging effects of lithotripsy and is characterized by a high degree of safety, which is very important during nephroprotective and lithokinetic therapy.