The use of Blamaren in combination with uricostatics for the treatment of hyperuricemic tubulointerstitial nephritis in combination with urate urolithiasis
M.M. Batyushin
FSBEI HE "Rostov State Medical University" of the RMH; Rostov-on-Don, Russia
Aim. Evaluation of the effect of chemolitholysis with Blamaren in combination with allopurinol or febuxostat therapy on the course of hyperuricemic TIN.
Patients and Methods. To achieve this goal, study included 43 patients at the age of 42.7±11.2 years (28 men, 15 women) with hyperuricemic TIN and urate urolythiasis, CKD 1-3B stages, with single or multiple concrements not more than 30 mm in diameter. The duration of the CKD was 3.7±4.2 years. The number of concrements was 1.4±1.1, the average size was 2.3±0.7 cm. The chemical analysis of urine and concrements in case of their discharge confirmed their urate nature.
Results. There was a decrease in the number of concrements during the treatment and at the end of the 9th week. As a result, concrements remained only in two of 43 patients (5 and 5 mm). In relation to these patients, it was decided to prolong the course of therapy with Blemaren for another 9 weeks. As a result, in one patient the concrement was lysed, and in the second patient it has decreased in size to 3 mm and discharged. Against the background of therapy, normalization of uric acid levels was observed, and it was accompanied by a gradual improvement in renal function (decrease in creatinine levels and increased GFR). This therapy had an effect on the severity of pathological changes in urinary sediments. In particular, there was a decrease in the proteinuria and albuminuria levels, as well as the severity of erythrocyturia.
Conclusion. The evaluation of the efficacy of uricostatics in combination with Blamaren in patients with hyperuricemic tubulointerstitial nephritis in combination with urate urolythiasis has demonstrated high efficacy not only in terms of chemolitholysis, but also in relieving the manifestations of nephritis and restoration of renal function.
About the Autors
Batyushin M. M. – Doctor of Medical Sciences, Head of the Department of Nephrology, Professor at the Department of Internal Diseases № 2 FSBEI HE RostSMU of RMH, Rostov-on-Don, Russia. E-mail: nephr-roon@rambler.ru
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