#03415 Comprehensive treatment program for children with urolithiasis

Abstract Background The search for the most non-invasive, safe for the body and gentle from the point of view of pain treatment of urolithiasis does not cease in the new millennium, despite the whole spectrum of technical progress in modern medicine. In the treatment of urolithiasis, the most significant is the prevention of the formation of a calculus at the stage of crystalluria, leveling of modifiable individual risk factors for the formation of NL and drug prophylaxis, especially at the risk of relapse. Consequently, no method of treating urolithiasis is applicable by itself, and the treatment of this pathology should be carried out by an adequate set of measures personalized for each patient. Aims Taking into account the type and degree of metabolic abnormalities in children, it is necessary to carry out its correction in terms of diet and drinking regimen, as well as drug therapy. Method The developed complex program of treatment and prevention of urolithiasis including diet, drinking regimen, forced urination regimen was used in 50 children with metabolic disorders in urine, whose average age was 3.85 ± 2.17 years. The children were divided into 2 groups: the main group consisted of 19 children who received cause-dependent treatment; the comparison group included 21 children who did not receive treatment due to parental refusal. Results Analysis of biochemical parameters of urine showed a reliable (<0.05) improvement in Ca/Cr, Oxalate/Cr, UA/Cr parameters in the main group (0.61 ± 0.04; 0.04 ± 0.00; 0.28 ± 0.02) compared to the initial level (0.92 ± 0.06; 0.11 ± 0.01; 0.52 ± 0.02) (P < 0.05), and in the comparison group these parameters did not have reliable differences—0.88 ± 0.07; 0.10 ± 0.01; 0.10 ± 0.01, respectively. Evaluation of the Mg/Cr level after 12 months of using the developed drug program demonstrated a reliable increase in the main group of 0.45 ± 0.03 relative to the initial level of 0.22 ± 0.02 (P < 0.05), in the comparative group this indicator was 0.24 ± 0.02. The citrate/Cr indicator, its concentration in the urine of the main group, was increased by 1.5 relative to the initial level, however, we were unable to statistically confirm the differences obtained, possibly due to the small number of observations. Conclusion The developed complex prevention of metabolic disorders in children with nephrolithiasis, including changes in eating habits, drinking regimen, forced urination regimen (every 2.5–3 hours), as well as correction of metabolic disorders depending on lithogenic and antilithogenic markers, showed an increase in the effectiveness of preventive drug measures and a 2.6-fold reduction in the risk of NL.

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