Kamalov A A, Okhobotov D A, Nizov A N
Medical Research and Educational Center, Lomonosov MSU, Moscow, Russia.
Lomonosov MSU, Faculty of Fundamental Medicine, Department of Urology and Andrology, Moscow, Russia.
Urologiia. 2018 Mar(1):15-19.
The study aimed to investigate the changes in the concentration of bikunin, osteopontin, and nephrocalcin, depending on the changes in the renal stone-forming activity in patients with recurrent urolithiasis.
The study comprised 152 patients with recurrent calcium oxalate stones at various localizations. Patients of the study group (n=78) were administered complex preventive treatment (water load, Blamaren, thiazide diuretics, oral calcium supplementation) aimed at reducing the activity of urolithiasis. Patients of the control group (n=74) received no treatment. The studied parameters included concentrations of urine bikunin, osteopontin, and nephrocalcin in using ELISA. The follow-up period was six months.
By the end of the follow-up, the bikunin concentration in the control group was significantly higher than in the study group (7.0+/-0.81 mg/ml vs. 3.28+/-0.86 mg/ml, respectively, p<0.05) while osteopontin level was significantly lower (2.4+/-0.39 mg/ml vs. 3.4+/-0.36 mg/ml, p<0.05). The nephrocalcin concentrations during the follow-up period did not change significantly (p>0.05). The presence of hypercalciuria did not lead to significant changes in the concentration of stone formation inhibitors.
The increase in bikunin concentration in control patients is associated with an increase in the expression of this stone formation inhibitor due to the rise in the urolithiasis activity. Reduction in the osteopontin concentration in patients with high urolithiasis activity is a consequence of osteopontin being a constituent of calcium oxalate stones.
In patients with calcium oxalate urolithiasis, testing for urine concentrations of bikunin and osteopontin as potential markers can be used to estimate the risk of stone recurrence.
本研究旨在根据复发性尿路结石患者肾结石形成活性的变化，调查 bikunin、骨桥蛋白和肾钙素浓度的变化。
本研究纳入了152例不同部位复发性草酸钙结石患者。研究组（n = 78）患者接受了旨在降低尿路结石活性的综合预防性治疗（水负荷、Blamaren、噻嗪类利尿剂、口服补钙）。对照组（n = 74）患者未接受治疗。使用酶联免疫吸附测定法研究的参数包括尿中bikunin、骨桥蛋白和肾钙素的浓度。随访期为6个月。
随访结束时，对照组中bikunin浓度显著高于研究组（分别为7.0±0.81mg/ml和3.28±0.86mg/ml，p<0.05），而骨桥蛋白水平显著较低（2.4±0.39mg/ml对3.4±0.36mg/ml，p<0.05）。随访期间肾钙素浓度无显著变化（p>0.05）。高钙尿症的存在并未导致结石形成抑制剂浓度的显著变化。
对照组患者中bikunin浓度的增加与尿路结石活性增加导致该结石形成抑制剂表达增加有关。尿路结石活性高患者骨桥蛋白浓度的降低是骨桥蛋白作为草酸钙结石成分的结果。
在草酸钙尿路结石患者中，检测尿中bikunin和骨桥蛋白浓度作为潜在标志物可用于评估结石复发风险。
