Personalized Litholytic Therapy With Blemaren: The Importance Of Density And Dimensional Characteristics Of Stones

Abstract

Litholytic therapy of urate stones is an important alternative to invasive methods of treating urolithiasis. The effectiveness of drugs such as Blemaren largely depends on the characteristics of the stones — their density and size. To evaluate the effect of the density and dimensional parameters of urate stones on the effectiveness of litholytic therapy with Blemaren. The study included 94 patients with urate stones who were prescribed Blemaren therapy. The density of the stones was estimated according to the MSCT data, and the size was estimated according to the maximum diameter. Follow-up examinations were performed after 4 and 8 weeks of therapy. The maximum efficacy (complete litholysis >85%) was achieved in patients with stones with a density of <400 HU and a size of <10 mm. With a density of >600 HU and a size of >15 mm, the efficiency was significantly reduced (<20%). Maintaining an optimal urine pH (6.2–6.8) significantly improved treatment outcomes. The density and size of the stone are key predictors of the success of Blemarene litholytic therapy. A personalized approach based on these parameters makes it possible to increase the effectiveness and rational use of medical resources.