The opportunity of litholytic therapy for stones of various compositions: an overview of potential solvents and prospects for further deve- lopment

Nesterova O.Yu., Makeeva E.A., Strigunov A.A., Tsigura D.A., Burlakov I.D., Okhobotov D.A., Kamalov A.A.

1) University Clinic, Medical Scientific and Educational Institute, Lomonosov Moscow State University. Moscow, Russian Federation; 2) Faculty of Fundamental Medicine, Medical Scientific and Educational Institute, Lomonosov Moscow State University, Moscow, Russian Federation

Urolithiasis is one of the most common diseases of the urinary system, which occurs in 12% of the world’s population and is characterized by an extremely high recurrence rate, reaching 75-80%. The rapid development of endourological lithotripsy techniques today makes it possible to completely remove stones from the urinary tract. Nevertheless, surgical interventions, despite their minimal invasiveness, are associated with a number of intra- and postoperative complications, as well as associated with high economic costs of the healthcare system. Thus, the high frequency of recurrence of the disease requires the search for new effective ways to remove stones from the urinary tract and prevent recurrence, both by affecting the mechanisms of stone formation and formed stones in order to dissolve them. To date, attempts are being made to litholysis stones of various compositions, but successful dissolution is possible only for urates that require urine alkalinization, primarily through the use of citrate and bicarbonate mixtures. In this regard, the purpose of this review is to assess the available possibilities of litholytic therapy of stones of various compositions and highlight the prospects for the development of this area. As part of the litholysis of calcium oxalate stones, the possibility of using oxalate-degrading microorganisms Oxalobacter formigenes, the use of substances with chelating ability, complexones, in particular ethylenediaminetetraacetic acid and its disodium salt, Trilon B. is being considered. The latter is also being studied in the aspect of calcium phosphate urolithiasis, along with renacidin and its analogues, which have the ability to acidify urine. Despite the variety of available techniques and a large number of studies of potential solvents in vitro and in vivo, litholysis of urinary stones, mainly calcium-based, still remains an elusive goal.

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About the Authors

Corresponding author: Olga Yu. Nesterova – M.D., Cand. Sc. (Med), Urologist, Researcher, Urology and Andrology Unit, University Clinic, Medical Scientific and Educational Institute, Lomonosov Moscow State University, senior lecturer of the Dept. of Urology and Andrology, Faculty of Fundamental Medicine, Medical Scientific and Educational Institute, Lomonosov Moscow State University. Moscow, Russian Federation; e-mail: oy.nesterova@gmail.com

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