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Nephrolithiasis are four urinary tract conditions that have similar symptoms but different causes. There is a congenital defect at the root of cystine urolithiasis, the remaining three - phosphate urolithiasis, oxalate and urolithiasis - result from dietary errors. Find out the symptoms of kidney stones. How to treat kidney stones and how to prevent kidney stones?

Urolithiasisdifferentlyurolithiasis(Latinnephrolithiasis ,urolithiasis ) occurs when chemicals precipitate in the kidneys and / or other parts of the urinary tract, forming plaque (stones). Usually, the first symptom that something bad is going on is an attack of kidney colic.

Men get urolithiasis four times more often than women. Usually these are men aged 30-50. Ladies are at risk of urolithiasis during pregnancy because then urinary stagnation and bacterial urinary tract infections are more common. Bacteria alkalize urine, and in an alkaline environment, calcium s alts precipitate faster, which promotes the formation of stones.

Renal colic attack

Severe pain and accompanying nausea, vomiting and hematuria is an attack of renal colic that heralds acute urolithiasis. Once a stone gets stuck in the urinary tract, urine cannot pass into the bladder. An infection then develops, leading to acute kidney failure.

An attack starts suddenly, e.g. after a lot of physical exertion, a long car trip, after drinking alcohol. Pain appears in the lumbar region, radiates along the ureter, to the lower abdomen and to the external genitalia. It is accompanied by abdominal distension and painful urge to urinate. The pain can be so strong that the sick lose consciousness. Narcotic painkillers may be required.

Causes of kidney stones

Urinary stonescan arise from both physiological compounds in urine and pathological ones. The kidneys filter the blood, i.e. they separate harmful or poisonous substances from it, and then remove them from the body along with the urine. Sometimes, however, some sediments remain at the bottom of the renal calyx. A sediment plate is formed.

If the plaque breaks down by itself, it will be removed by a natural route, ie through the urinary tract into the bladder and then through the urethra to the outside. IfNo.

It happens when the concentration of compounds that can form kidney stones exceeds the so-called the threshold of solubility in the body. Contribute to this:

  • hereditary tendencies
  • defects in the structure of the urinary system
  • urinary tract infections
  • taking certain medications (e.g. glucocorticosteroids)
  • hyperparathyroidism
  • gastrointestinal diseases (inflammatory bowel diseases such as Crohn's disease, malabsorption syndrome)
  • long-term treatment of peptic ulcer with alkalizing preparations (reducing gastric acid secretion)
  • excessive concentration of urine (e.g. by restricting drinking, causing dehydration)
  • overdose of vitamin D3, vitamin C, calcium
  • bad diet

Symptoms of kidney stones

Nephrolithiasis usually does not give any symptoms for many years, although of course it can be detected by accident, e.g. during an X-ray or ultrasound of the abdominal cavity. The patient is usually told that he has a problem with kidney stones when he has a kidney colic attack.

It happens when a stone closes the lumen of the urinary tract, causing the kidneys or kidneys to swell and triggering an attack of renal colic. This is a condition that requires immediate specialist intervention. First, you need to relieve the unbearable pain quickly - it's so intense that it's often accompanied by nausea and vomiting.

Second, prolonged anuria leads to kidney damage. Very severe pain in the form of colic usually affects the abdomen, flank, and also the groin, depending on the sex - testicles or labia.

In addition, during the "birth" of a stone, hematuria, pain during urination, frequent urination, painful, sudden pressure on the bladder and difficulties in maintaining it may occur. There is also usually elevated temperature, pale skin, and feelings of restlessness and discomfort.

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Types of kidney stones

  • Cystine calculi

It touches 1 percent. sick.

Causes:is a birth defect. It consists in impaired absorption of cystine, i.e. an amino acid.

Treatment:The basis is a diet that limits the amount of cystine and methionine. Penicillamine can be administered, which forms soluble compounds with cystine.

Diet:the basis should be milk, its products and plant products. It is necessary to drink plenty of fluids. Meat consumption should be limited andhis preserves.

  • Phosphate stones (struvite)

Suffers from 5 to 10 percent of it. sick.

Causes:frequent urinary tract infections with urease-producing bacteria such as Proteus, Klebsiella and Pseudomonas. Urease is the breakdown of urea into ammonia, making the urine alkaline.

Treatment:acidifying the urine is the most important. However, this cannot be achieved by diet alone. It is necessary to take acidifying drugs.

Diet:is about avoiding foods rich in calcium and phosphates, i.e. legume seeds, and limiting potatoes, vegetables and fruits, as well as milk and eggs. Fish, groats, pasta, bread, butter, meat are recommended.

  • Oxalate (calcium oxalate) stones

Applies to 70 to 80 percent patients with urolithiasis.

Causes:it may be hyperparathyroidism, vitamin D3 overdose, excessive excretion of calcium, citrates and oxalates from the body.

Treatment:increasing the amount of fluids to 4-5 liters per day. Medicines that trap calcium in the digestive tract and reduce its excretion in the urine.

Diet:is mainly about limiting the consumption of oxalate. Exclude chocolate, cocoa, spinach, rhubarb, sorrel, lemons, beets, hot spices, alcohol, orangeades, coca-cola, coffee and tea; limit - potatoes, tomatoes, peas, plums, strawberries.

Yeast, sprouts, eggs, wholemeal bread, groats, lean meat, fish, poultry, cucumbers, lettuce, butter, onions and fruit are recommended.

  • Gout

They suffer from it from 5 to 10 percent. patients.

Causes:develops when the urine pH is acidic or the body is producing excess uric acid. It also affects patients with lymphomas, leukemia and bone marrow diseases.

Treatment:is easy because the stones can be dissolved by taking the right pills. There are also agents that change the acidic reaction of the urine to alkaline.

Diet:must reduce the acidity of the urine. This can be achieved by serving dairy dishes and large amounts of vegetables and fruit. The second rule is to limit the foods that are sources of purines (purine bases) found in offal (liver, lung, tongue, kidney, brain and heart), stocks, jellies and gravies, sardines and herring. Legumes (peas, beans, lentils and broad beans) and mushrooms are rich in purines. They also contain cocoa, coffee and tea.

Better to avoid pork, beef, lamb. It is best to steam and meat - in large amountswater. Lean poultry and veal are recommended. Their amount in the daily food ration should not, however, exceed 100-150 g.

Vegetables, fruit, sugar, small amounts of butter, milk, lean cheese, potatoes are recommended. The total daily caloric content of food should not exceed 2000-2200 kcal.

Herbs fighting this form of urolithiasis are the leaves of lingonberry, black currant, birch and couch grass. A glass of decoction from such a mixture should be drunk at least 3 times a day between meals.

Treatment of kidney stones

70 percent patients can be treated pharmacologically. Operations are only used on large stones, although doctors more and more often choose non-invasive techniques.

Surgical removal of urinary stones is used very rarely, because modern, less invasive methods are equally effective.

  • Transcorporal lithotripsyconsists in breaking down the urinary stone inside the patient's body using the so-called shock wave. The procedure is usually performed on an outpatient basis and does not require anesthesia. The crushed stone is then excreted naturally.
  • Percutaneous nephrolithotripsyis performed under anesthesia. It consists in inserting a nephoscope into the renal pelvis through a small incision in the skin near the kidney, through which the doctor can view the stone, determine its location and use appropriate tools to break it up and then remove it.
  • Ureterorenoscopyis performed under anesthesia. The doctor passes a flexible speculum through the urethra, into the bladder and then into the ureter. The scale can be inspected through the sight glass and, using appropriate tools, removed in full or broken up into smaller pieces.
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Urology and Nephrology