Gender characteristics of hematuria during lithokinetic therapy in patients with nephrolithiasis

DOI: https://doi.org/10.29296/25877305-2024-02-07
Issue: 
2
Year: 
2024

Professor E. Barinov, MD; Kh. Grigoryan, Candidate of Medical Sciences;
S. Akhundova; A. Yureva; D. Giller
M. Gorky Donetsk State Medical University, Ministry of Health of Russia

Purpose. To study gender characteristics of the severity of hematuria and compensatory mechanisms of the proaggregant component of hemostasis in patients with nephrolithiasis when prescribing litokinetic therapy (LCT), including nonsteroidal anti-inflammatory drugs (NSAIDs). Material and methods. The prospective study included 60 patients (group 1 – 30 men; group 2 – 30 women) with imaging signs of the presence of stones in the urinary tract. For 7 days, patients underwent standard LCT, including NSAIDs, an α1A-blocker (tamsulosin) and antibiotics. In vitro, the activity of the TP receptor for TxA2 and purine P2Y receptors (P2Y1 and P2Y12) was studied on a platelet suspension after 24, 48, 72 hours, 5 and 7 days. Platelet aggregation was assessed using the turbidimetric method using a ChronoLog analyzer (USA). Results. At the hospitalization stage, in both groups (before the introduction of NSAIDs), hyperreactivity of the TP-receptor was observed, and in men the activity of the TP receptor was lower, and hematuria (p
Keywords: 
nephrolithiasis
lithokinetic therapy
non-steroidal anti-inflammatory drugs
gender characteristics
hematuria
TхA2
purinergic signaling.

References: 
  1. Campschroer T., Zhu X., Vernooij R.W. et al. Alpha-blockers as medical expulsive therapy for ureteral stones. Cochrane Database Syst Rev. 2018; 4 (4): CD008509. DOI: 10.1002/14651858
  2. Golomb D., Shemesh A., Goldberg H. et al. Effect of gender on presentation and outcome of renal colic. Urologia. 2023; 12: 3915603221150039. DOI: 10.1177/03915603221150039
  3. Iseki K., Konta T., Asahi K. et al. Higher cardiovascular mortality in men with persistent dipstick hematuria. Clin Exp Nephrol. 2021; 25 (2): 150–6. DOI: 10.1007/s10157-020-01971-z
  4. Carazo A., Hrubša M., Konečný L. et al. Sex-Related Differences in Platelet Aggregation: A Literature Review Supplemented with Local Data from a Group of Generally Healthy Individuals. Semin Thromb Hemost. 2023; 49 (5): 488–506. DOI: 10.1055/s-0042-1756703
  5. Wickham K.A., Nørregaard L.B., Lundberg Slingsby M.H. et al. High-Intensity Exercise Training Improves Basal Platelet Prostacyclin Sensitivity and Potentiates the Response to Dual Anti-Platelet Therapy in Postmenopausal Women. Biomolecules. 2022; 12 (10): 1501. DOI: 10.3390/biom12101501
  6. Jiang R.-S., Zhang L., Yang H. et al. Signalling pathway of U46619-induced vascular smooth muscle contraction in mouse coronary artery. Clin Exp Pharmacol Physiol. 2021; 48 (7): 996–1006. DOI: 10.1111/1440-1681.13502
  7. Nagatsuka K., Miyata S., Kada A. et al. Cardiovascular events occur independently of high on-aspirin platelet reactivity and residual COX-1 activity in stable cardiovascular patients. Thromb Haemost. 2016; 116 (2): 356–68. DOI: 10.1160/TH15-11-0864
  8. Fan L., Cao J., Liu L. et al. Frequency, risk factors, prognosis, and genetic polymorphism of the cyclooxygenase-1 gene for aspirin resistance in elderly Chinese patients with cardiovascular disease. Gerontology. 2013; 59 (2): 122–31. DOI: 10.1159/000342489
  9. Cavallari L.H., Helgason C.M., Brace L.D. et al. Sex difference in the antiplatelet effect of aspirin in patients with stroke. Ann Pharmacother. 2006; 40 (5): 812–7. DOI: 10.1345/aph.1G569
  10. Dorsam R.T., Kim S., Jin J. et al. Coordinated signaling through both G12/13 and G(i) pathways is sufficient to activate GPIIb/IIIa in human platelets. J Biol Chem. 2002; 277 (49): 47588–95. DOI: 10.1074/jbc.M208778200
  11. Shankar H., Kahner B.N., Prabhakar J. et al. G-protein-gated inwardly rectifying potassium channels regulate ADP-induced cPLA2 activity in platelets through Src family kinases. Blood. 2006; 108 (9): 3027–34. DOI: 10.1182/blood-2006-03-010330
  12. Kälvegren H., Skoglund C., Helldahl C. et al. Toll-like receptor 2 stimulation of platelets is mediated by purinergic P2X1-dependent Ca2+ mobilisation, cyclooxygenase and purinergic P2Y1 and P2Y12 receptor activation. Thromb Haemost. 2010; 103 (2): 398–407. DOI: 10.1160/TH09-07-0442
  13. Coleman J.R., Moore E.E., Kelher M.R. et al. Female platelets have distinct functional activity compared with male platelets: Implications in transfusion practice and treatment of trauma-induced coagulopathy. J Trauma Acute Care Surg. 2019; 87 (5): 1052–60. DOI: 10.1097/TA.0000000000002398
  14. Schubert P., Coupland D., Nombalais M. et al. RhoA/ROCK signaling contributes to sex differences in the activation of human platelets. Thromb Res. 2016; 139: 50–5. DOI: 10.1016/j.thromres.2016.01.007
  15. Gasecka A., Zimodro J.M., Appelman Y. Sex differences in antiplatelet therapy: state-of-the art. Platelets. 2023; 34 (1): 2176173. DOI: 10.1080/09537104.2023.2176173
  16. Wang T.Y., Angiolillo D.J., Cushman M. et al. Platelet biology and response to antiplatelet therapy in women: implications for the development and use of antiplatelet pharmacotherapies for cardiovascular disease. J Am Coll Cardiol. 2012; 59 (10): 891–900. DOI: 10.1016/j.jacc.2011.09.075
  17. Romano S., Buccheri S, Mehran R. Gender differences on benefits and risks associated with oral antithrombotic medications for coronary artery disease. Expert Opin Drug Saf. 2018; 17 (10): 1041–52. DOI: 10.1080/14740338.2018.1524869
  18. Hadley J.B., Kelher M.R., D'Alessandro A. et al. A pilot study of the metabolic profiles of apheresis platelets modified by donor age and sex and in vitro short-term incubation with sex hormones. Transfusion. 2022; 62 (12): 2596–608. DOI: 10.1111/trf.17165
  19. Caiazzo E., Bilancia R., Rossi A. et al. Ectonucleoside Triphosphate Diphosphohydrolase-1/CD39 Affects the Response to ADP of Female Rat Platelets. Front Pharmacol. 2020; 10: 1689. DOI: 10.3389/fphar.2019.01689
  20. Birk A.V., Broekman M.J., Gladek E.M. et al. Role of extracellular ATP metabolism in regulation of platelet reactivity. J Lab Clin Med. 2002; 140 (3): 166–75. DOI: 10.1067/mlc.2002.126719