International Medical Journal, Vol. 21., Iss. 3, 2015, P. 63−69.
PHARMACOTHERAPY OF METABOLIC SKELETAL LESIONS AGAINST A BACKGROUND OF RECURRENT NEPHROLITHIASIS
Lopatkin Institute of Urology and Interventional Radiology, branch of Fed.State Budget Establishment NMIRC, Ministry of Health of Russian Federation, Russian Federation
The data from modern literature on the metabolic involvement of skeletal bone therapy against a background of recurrent nephrolythiasis were analyzed. Basic groups of medication used for this purpose were considered: vitamin D and its active metabolites, bisphosphonates, citrates and thiazides. Usage of vitamin D and its active metabolites (alfacalcidolum and rokaltrolum) in such clinical situation is questionable, mostly because of absence of definite confirmation of non−increasing recurrence risk of nephrolythiasis against a background of such medication usage. In addition, there is information about negative impact of this medication on the cardiovascular system. Combining scheme, including a thiazid diuretic and citric acid salt, has a confirmed, but very weak effect, not always acceptable for clinical use. Bisphosphonates showed comparatively high effectiveness against a background of the available level of safety. Possibility of combining usage of bisphosphonates and thiazid diuretics is discussed, but the data about effectiveness and safety of such treatment are lacking.
Key words: nephrolythiasis, renal osteodystrophy, bisphosphonates, vitamin D, citrates, thiazides.