Дистанционный мониторинг показателей общего анализа мочи при лечении цитратными смесями пациентов с мочекислым уролитиазом

Abstract

Oral dissolution therapy has been successfully used in urologic practice since 1950s. However, many doctors attempt to improve efficiency of this approach. Use of different medical personalized digital devices which are increasingly used in clinical practice, represent one of the solutions of this problem. Our aim was to assess efficiency of oral dissolution therapy with drug Blemaren in patients with uric acid stones using of portable urinary analyzer with system of remote monitoring. A total of 12 patients with uric acid stones were followed. All of them had kidney stone with a density less than 500 HU according to CT-urography. Oral dissolution therapy was performed with the drug Blemaren for 8-9 weeks. All patients were advised to maintain urine pH of 6.5-7.0. With aim of dynamic monitoring of urine parameters, a portable urine analyzer "ETTA AMP-01" was given to all patients for 2 months. Complete dissolution was achieved in 10 (83.3%) patients. In one case (8.3%) oral dissolution therapy was complicated by acute pyelonephritis. A stenting was performed and dissolution therapy was continued with a positive effect. In another case (8.3%) partial dissolution was seen, however, extracorporeal shockwave lithotripsy was decided to perform. Doctor who remotely monitored different parameters of urinalysis (n=11) followed urine pH, density, leukocytes, erythrocytes, level of nitrite, which provided a more comprehensive assessment of patients current state. If necessary, the specialist contacted the patient and adjusted the therapy. The possibility of remote monitoring of urinalysis and simple communication with urologist allows to titrate drug dose more convenient compared to conventional approach when outpatient urologist controls pH diaries based on dip-stick test. Moreover, such approach gives an opportunity to quickly identify complications and correct the therapy in a timely manner.