Modern pathogenetic aspects of urolithiasis development

Аннотация

World experience accumulated in the study of the problem from the standpoint of various fields of knowledge indicates that urolithiasis is probably the COPYRIGHT most polyetiological disease with a very complex © 2025 Original content from this work may be used under the terms pathogenesis. Despite the successes achieved in the of the creative commons attributes 4.0 License. treatment of urolithiasis, relapses of the disease within 5 years can occur in 50% of patients. Today, some genetic polymorphisms associated with urolithiasis are of particular interest: uromodulin, which is involved in the regulation of vitamin D metabolism and calcium metabolism. The study of the problem of urolithiasis has reached a qualitatively new level in recent years due to the use of a multidisciplinary approach and the principles of evidence-based medicine. The expansion of the study of the etiology and pathogenesis of the disease, the development and application of high-tech diagnostic and treatment methods have made it possible to solve many problems. Keywords: Urolithiasis, gene polymorphism, pathogenesis, etiological factor, diagnostics, morbidity. Introduction: Urolithiasis (urolithiasis) is one of the most pressing health problems worldwide, as its prevalence increases annually by 0.5–5.3%. The significant prevalence of urolithiasis in the population (at least 5% of the population of industrialized countries) forces us to constantly study the etiology and pathogenesis, look for effective mechanisms for prevention and metaphylaxis, improve diagnostic methods, and develop new technologies for The American Journal of Medical Sciences and Pharmaceutical Research 21 https://www.theamericanjournals.com/index.php/tajmspr The American Journal of Medical Sciences and Pharmaceutical Research conservative and surgical treatment [1]. The incidence or decrease in the incidence of nephrolithiasis. varies greatly in different countries of the world, Biogeochemical characteristics of the territory in which averaging: 1–5% in Asia, 5–9% in Europe, 13% in North the indigenous population permanently resides also America, and up to 20% in Saudi Arabia [2]. affect the incidence of urolithiasis to one degree or another. The main causes here are the physicochemical The importance of urolithiasis has become especially state of the soil, drinking water and local food products relevant in recent years due to global demographic depending on the level of micro-, macroelements and shifts. The constant shift in the age pyramid of society vitamins [11, 12]. in developed countries towards an increase in the proportion of elderly and old age groups leads to an Endogenous etiological factors include changes in increase in the incidence of urolithiasis, which is 8.8% kidney tissue [13], pathological changes in the kidneys, in men and 5.6% in women in the 65–69 age group, urinary tract and urodynamics [14, 15], impaired compared to 3.7% and 2.8%, respectively, in the 30–34 microcirculation in the kidneys and the presence of age group [3]. The prevalence of urolithiasis in infection in them [16], changes in the composition of countries such as the USA, Italy, Germany, Spain, and urine, increased excretion of lithogenic substances [1]. Japan has doubled over the past 20 years, and has Among the leading endogenous etiological factors in the increased especially rapidly in recent years [4]. Despite development of nephrolithiasis, great importance is the advances made in the treatment of urolithiasis, attached to genetic factors, which can cause the relapses of the disease within 5 years may occur in 50% development of polygenically inherited of patients. World experience accumulated in the membranopathy, congenital and acquired study of the problem from the perspective of various enzymopathies, tubulopathies and metabolic fields of knowledge indicates that urolithiasis is nephropathies, as well as some monogenic forms of probably the most polyetiological disease with a very lithogenic substance metabolism disorders [17]. In the complex pathogenesis. There is still no unified concept last decade, the main direction of studying the genetic of the pathogenesis of urolithiasis. The development of risk factors for the development of urolithiasis has been the disease is associated with a number of complex the identification of its association with polymorphic physicochemical processes occurring both in the body variants of a particular gene. In foreign studies, an as a whole and in the kidney and urinary tract. association was found between the occurrence of Currently, urolithiasis is considered a multi-etiological urolithiasis and the polymorphism of some genes, such disease resulting from dysfunction of the urinary as KL [18], VDR [20], CASR [19], ORAI1 [21]. The N. A. system, gastrointestinal tract, genetic, hormonal and Lopatkin Research Institute of Urology and metabolic disorders [5]. Although the so-called "non- Interventional Radiology is also conducting stu