Metabolic bone lesions in the background of nephrolithiasis

Urolithiasis takes one of the first places in the structure of urological diseases. Kidney and urinary tract stones are detected in 30-45% of patients admitted to urological hospitals. Significant aspects are direct correlation between the stone chemical structure and increased excretion of any salt, as well as the pH of urine, from which the solubility of the salts is strongly dependent. These patterns are at the basis metaphylcatic measures. Despite the obvious relevance and social importance of the subject the problem of metabolic osteopathy in the background of recurrent nephrolithiasis is covered in contemporary publications insufficiently. Most of the information on this subject is contained in reference and educational publications, original articles are very few. Domestic and foreign guidelines, the original papers reflect the pathophysiology of disorders of mineral metabolism in kidney diseases, the causes and manifestations of Fanconi syndrome, in which there is tubular acidosis, aminoaciduria, phospha-turia, polyuria, proteinuria, tubular type, glucosuria. These violations of tubular function may be either congenital or acquired. The possibility of formation of phosphate stones, renal osteodystrophy development against the backdrop of the proximal tubule dysfunction (in high phosphaturia renal calculi is natural, as far as a progressive decrease in bone mineral density, leading to bone pain, skeletal deformities, fractures). Schemes of treatment of Fanconi syndrome, phosphate diabetes, renal osteodystrophy are presented. We also present experimental data on the impact of drugs on bone mineral density in patients with recurrent nephrolithiasis.