agxАндрология и генитальная хирургияAndrology and Genital Surgery2070-97812412-890210.17650/2070-9781-2022-23-4-36-45agx-614Research ArticleОБЗОРНАЯ СТАТЬЯREVIEWМаркеры литогенной активности при мочекаменной болезниMarkers of lithogenic activity in kidney stone diseasehttps://orcid.org/0000-0002-9064-7881АлфимовА. Е.AlfimovA. E.

Александр Евгеньевич Алфимов

119991 Москва, ул. Трубецкая, 8, стр. 2

Alexandr Evgenyevich Alfimov

Bld. 2, 8 Trubetskaya St., Moscow 119991

alfimov_a_e@staff.sechenov.ruhttps://orcid.org/0000-0003-0639-3274ШадеркинаА. И.ShaderkinaA. I.

119991 Москва, ул. Трубецкая, 8, стр. 2

Bld. 2, 8 Trubetskaya St., Moscow 119991

https://orcid.org/0000-0001-8861-8187КоролевД. О.KorolevD. O.

119992 Москва, ул. Большая Пироговская, 2, стр. 1 

Bld. 1, 2 Bolshaya Pirogovskaya St., Moscow 119992

ГориноваД. М.GorinovaD. M.

119992 Москва, ул. Большая Пироговская, 2, стр. 1 

Bld. 1, 2 Bolshaya Pirogovskaya St., Moscow 119992

ЕникеевМ. Э.EnikeevM. E.

119992 Москва, ул. Большая Пироговская, 2, стр. 1 

Bld. 1, 2 Bolshaya Pirogovskaya St., Moscow 119992

ЦариченкоД. Г.TsarichemkoD. G.

119992 Москва, ул. Большая Пироговская, 2, стр. 1 

Bld. 1, 2 Bolshaya Pirogovskaya St., Moscow 119992

https://orcid.org/0000-0001-7787-1240РапопортЛ. М.RapoportL. M.

119992 Москва, ул. Большая Пироговская, 2, стр. 1 

Bld. 1, 2 Bolshaya Pirogovskaya St., Moscow 119992

ФГАОУ ВО Первый Московский государственный медицинский университет им. И.М. Сеченова Минздрава России (Сеченовский Университет)РоссияI.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)Russian FederationИнститут урологии и репродуктивного здоровья человека ФГАОУ ВО Первый Московский государственный медицинский университет им. И.М. Сеченова Минздрава России (Сеченовский Университет)РоссияInstitute of Urology and Human Reproductive Health of the I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)Russian Federation2022080120232343645Copyright © Алфимов А.Е., Шадеркина А.И., Королев Д.О., Горинова Д.М., Еникеев М.Э., Цариченко Д.Г., Рапопорт Л.М., 20232023Алфимов А.Е., Шадеркина А.И., Королев Д.О., Горинова Д.М., Еникеев М.Э., Цариченко Д.Г., Рапопорт Л.М.Alfimov A.E., Shaderkina A.I., Korolev D.O., Gorinova D.M., Enikeev M.E., Tsarichemko D.G., Rapoport L.M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://agx.elpub.ru/jour/article/view/614

Литогенный процесс развивается незаметно. Было предложено несколько маркеров для выявления активации литогенного процесса. В данном обзоре мы проанализировали опубликованные данные о принципах действия этих диагностических тестов и описали 6 групп маркеров литогенной активности: 1) концентрация в моче камнеобразующих и ингибирующих ионов, а также производные от них соотношения, индексы и степени перенасыщения камнеобразующими соединениями; 2) макромолекулы и другие молекулы-маркеры, определяемые в моче; 3)физические свойства мочи; 4) маркеры крови; 5) маркеры, определяемые инструментальными методами; 6) тесты индуцированной кристаллизации мочи. Самыми перспективными и наиболее успешными маркерами литогенной активности являются тесты индуцированной кристаллизации мочи, которые могут применяться для выявления периодов повышенной литогенной активности, что может дать возможность предотвратить камнеобразование за счет своевременного усиления терапии. Наличие доступного и удобного маркера литогенной активности, применяемого регулярно в системе дистанционного мониторинга, позволит реализовать персонализированную программу предотвращения рецидивов мочекаменной болезни. 

Kidney stones develop silently. Several markers revealing the activation of lithogenic process were proposed. Here we review the technologies behind these diagnostic tests and describe six groups of lithogenic activity markers: 1) indices and calculated supersaturations, based on concentration of stone forming and inhibiting ions in 24h-urine; 2) macromolecules or specific molecules in urine; 3) urine physical properties, 4) blood markers; 5) instrumental methods; 6) induced urinary crystal formation tests. The induced urinary crystal formation group is the most promising and successful. These tests can be used for revealing the periods of high lithogenic activity and guiding prompt treatment intensification. Convenient and affordable markers of lithogenic activity, applied regularly and remotely, make effective personalized recurrence prevention programs feasible. 

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