Kidney stones ( urolithiasis ) , causes, symptoms , treatment, prevention of kidney stones
Urology / / August 12, 2017
Kidney Stones video
Urolithic disease - kidney disease and urinary tract, characterized by the formation of stones (calculi) in the kidney and urinary tract stones.Therefore, the disease was referred to as kidney stones.
Urolithiasis or nephrolithiasis is the medical term used to describe stones that form in the urinary tract.
urinary tract or system consists of the kidneys, ureter, bladder and urethra.Two kidney bean-shaped organ located below the middle of the back ribs, one on each side of the spine.The kidneys remove excess water and waste products from the blood, participating in the production of urine.They also maintain a stable balance of salts and other substances in the blood.The kidneys produce hormones that help build strong bones and formation of red blood cells.
Doctors also use terms that describe the arrangement of stones in the urinary tract.For example, when the ureteral calculi detected ureterolitiaz term use, the presence of stones in the urinary tract anywhere called urol
Kidney stones are one of the most painful of the urologic disorders that people suffer for centuries.Scientists have found evidence of this, finding stones in the kidneys, in the 7000-year-old Egyptian mummy.Unfortunately, kidney stones are one of the most common urinary tract infections.
Kidney stones are solid mass consisting of tiny crystals.At the same time in the kidney or ureter may be one or more stones are formed when urine becomes too concentrated and substances in urine crystallize to form stones.Symptoms occur when the stones start to move down the ureter, causing severe pain.
Causes and risk factors for kidney stones
- Dehydration. Dehydration from reduced fluid intake or strenuous exercise without adequate fluid replacement increases the risk of kidney stones.Barrier to the flow of urine can also lead to the formation of stones.In this regard, the climate can be a risk factor for the development of nephrolithiasis, as inhabitants of hot and dry areas are more likely to experience dehydration and are sensitive to the formation of kidney stones.
- Chronic urinary infection. Kidney stones may also result from infection in the urinary tract, such as cystitis and pyelonephritis.
- Metabolic disorders. Metabolic disorders, including hereditary disorders of metabolism, can change the composition of the urine and increase a person's risk for stone formation.
- Violation of calcium metabolism in the body - hypercalciuria. Other hereditary disease characterized by a high content of calcium in the urine, causes stones in more than half of the cases.In this state, too much calcium is absorbed from food and excreted in the urine where it can form calcium phosphate or calcium oxalate stones.
- Gout.Gout leads to chronic increase in the amount of uric acid in blood and urine, which can lead to the formation of uric acid stones.
- Anomalies of the kidneys and kidney disease. increased risk of kidney stones have the people, suffering from hyperparathyroidism, renal tubular acidosis, cystinuria and hyperoxaluria, narrowing of the ureter, renal anomalies of development, polycystic kidneys.
- Diabetes and hypertension. Chronic diseases such as diabetes and high blood pressure are also associated with an increased risk of developing kidney stones.
- Diseases of the digestive tract. people with inflammatory bowel disease were also more likely to develop kidney stones because of disorders of calcium metabolism and to an increase in the concentration of substances in the blood kamneobraschuyuschih.Past intestinal bypass surgery or stoma, and an increased risk of kidney stones.
- Receiving drugs. Some drugs also increase the risk of kidney stones.These medications include some diuretics, calcium-containing antacids, and the protease inhibitor indinavir, a drug used to treat HIV infection.
- Power. Dietary factors may increase the risk of stone formation in susceptible people, especially high intake of animal protein, high salt content, excessive consumption of sugar, surplus vitamin D, and possibly excessive consumption of oxalate-products, such as spinach.
- Physical inactivity. sedentary lifestyle and mostly sedentary work leads to disruption of calcium-phosphorus metabolism, and stagnation in the pelvis, which in turn causes the formation of stones in the urinary system.
Types of kidney stones
Kidney stones form when urine contains too much of certain substances.These substances can create small crystals that are stones.Formation of the stone may take several weeks or months.There are different types of kidney stones:
- Calcium stones (vedellit, vevellit, apatite, brushite, whitlokite). Calcium kidney stones are the most common.They are more common in men aged 20 - 30 years.Calcium is usually combined with other substances, such as oxalates, phosphates or carbonates, the formation rocks.Oxalates are present in some foods, such as spinach.They are also found in supplements of vitamin C. Diseases of the small intestine increase the risk of these stones.Interestingly, low levels of calcium in the diet can lead to a change in the balance of calcium oxalate and lead to an increase in oxalate excretion and tendency to form calcium oxalate stones.
- cystine stones or protein. cystine - a substance that is a component of muscles, nerves and other parts of the body.Cystine stones can form in people who are prone to cystinuria.This disease is inherited and affects equally men and women.
- Magnesium stones (Newbury, struvite) .Struvity occurs mainly in women who have urinary tract infections.These stones can be very large and can block the kidneys, ureters or bladder.
- Stones uric acid (urate of sodium, ammonium urate). Urata are more common in men than in women.They can occur with gout or chemotherapy.
- Mixed stones. Other substances, including drugs such as acyclovir and indinavir triamterene, stones can also be formed.
symptoms of kidney stones (urolithiasis)
Typically, kidney stones do not have symptoms until the stones begin to move down the ureters into the bladder.When this occurs, the stones may block the flow of urine from the kidney.
main symptom is severe pain that starts suddenly and may just stop abruptly.The pain has been described by many as the worst pain of my life, even worse than the pain in childbirth or from broken bones.
main symptoms of kidney stones usually include:
- Pain in the abdomen or waist, called renal colic.It can be so strong that it is often accompanied by nausea and vomiting and can be given in the groin, hip or egg.
- Abnormal, muddy color
urine - Blood in the urine
- Sand in
urine - Frequent urination
- Difficult and painful urination
Chills - Fever
Nausea - Vomiting.
diagnosis of kidney stones (urolithiasis)
diagnosis of a kidney stone is suspected, marking the typical pattern of symptoms and rule out other possible causes of pain in the abdomen or side.Typically, diagnosis of kidney stones is not difficult.
- Blood tests to determine the content of calcium, phosphorus, uric acid, and electrolytes.
- Urine analysis allows you to see crystals and red blood cells in the urine, as well as to determine the type of stone.
- ultrasound of the kidneys and abdomen.
- abdominal CT detects stones or obstruction in the urinary tract
- MRI of the kidneys and the abdominal area
- X-ray abdomen
- Intravenous pyelogram.During the procedure, the patient is administered a radiopaque dye, and X-rays pass through the urinary tract.This procedure is performed to confirm the presence of kidney stones, rocks although some may be too small to be visible.
- Retrograde pyelogram.
Treatment of kidney stones (urolithiasis)
urolithiasis Treatment depends on the type of stone and the severity of symptoms.Most
kidney stones will eventually pass through the urinary tract spontaneously within 48 hours at the use of a sufficient amount of liquid.For the relief of symptoms may be prescribed painkillers.However, pain can be strong enough that required narcotic pain medication.Some patients with severe pain of kidney stones in a hospital stay is required to receive fluid intravenously.
Depending on the type of stone, the drug may be prescribed to reduce the formation of stones, to help dissolve and remove the material which forms the stone.Normally used:
- allopurinol (for uric acid stones)
- Antibiotics (for struvite)
- sodium bicarbonate or sodium citrate
- thiazide diuretics.
There are several factors that affect the ability of the independent passage of the stone.These include human dimensions, prostate enlargement, rubble and pregnancy.Stones to 4 mm have 80% probability of passing, while stones of a size of 5 mm is already a 20% chance.Stones more than 9-10 mm rarely pass on their own and usually require treatment.
Surgical treatment of kidney stones is usually required if:
- The stone is too large to go out on their own
- Stone grows
- stone blocks the flow of urine and cause an infection or kidney damage
- Pain is not withdrawn pain medicine.
Modern medicine offers a minimally invasive treatment of kidney stones, such as:
- Extracorporeal shock wave lithotripsy or laser. It is used to remove small stones, which are located near the kidney or ureter.The method is based on the action of ultrasound or laser to break up the stone.After this procedure, stone, crushed to sand, leaves the body in urine.
- Percutaneous nephrolithotomy. This procedure is used for large kidney stones in the kidney or in the case of renal anomalies.The stone is removed endoscope which is inserted into the kidney through a small surgical incision.
- Ureteroscopy. Ureteroscopy performed in the presence of stones in the lower urinary tract.Cystoscopy consists of a hollow metal tube provided with optical and lighting systems.It is inserted through the urethra and allows you to explore the urethra throughout, the bladder, as well as perform the necessary surgical and therapeutic manipulation.
- nephrolithotomy. open surgery may be needed if other methods do not work or are not possible.Nephrolithotomy in the treatment of kidney stones is used today in very rare cases.
- reasons urolithiasis
- pyelonephritis, causes, symptoms, treatment of pyelonephritis
- Infusions of herbs kidney disease
fragmentation of kidney stones with ultrasound - percutaneous lithotripsy
percutaneous lithotripsy, a medical procedure that uses shock waves and ultrasound to break up kidney stones, bladder or ureter (the tube that carries urine from the kidney to the bladder).The ultrasonic waves pass through the body until their paths do not meet the dense stones.The pulses of sound waves break up the stones, which are then more easily pass through the ureter and excreted in the urine.
lithotripsy procedure usually takes from 45 minutes to 1 hour.
patient usually lies on the operating table on a cushion filled with water or immersed in the bath so as to provide a direct effect of shock waves on the stone.Position during lithotripsy stone is monitored using fluoroscopy or ultrasound.Before the procedure is administered intravenously ?? mild sedative or pain medicine that the operation was painless.Perhaps before the procedure is necessary to start taking antibiotics to prevent infection.
in the bladder or kidneys can be inserted into a catheter or stent, which would remove the urine from the kidney to the fragments of stone, which was destroyed during lithotripsy, not clogged the ureter until all the small pieces of stone out of the body.The catheter may be placed before or after lithotripsy.
Lithotripsy painless, during the procedure, you can feel the pressure and tapping on the skin.
Currently, the newest method of lithotripsy to treat kidney stones and urinary tract is laser lithotripsy.This procedure uses a laser to break up kidney stones into small pieces.stone parts can be removed during the procedure or may extend from the body in urine.According
urethra held an endoscope, which is further promoted through the ureter directly to the stone.
to security procedures is monitored by cystoscopy.The thermal energy of the laser destroys the stone not by crushing but by melting.Due to the flexibility of the endoscope and the control procedure can be applied to various treatments depending on the location and shape of the stone.For example, small stones are fragmented immediately, whereas large calculi are destroyed by creating holes in the center, after which edges can be fragmented.Finally, masonry remnants may be washed using an endoscope and the washing liquid.
There are many different types of lasers used in medicine.To remove kidney stones are usually used Holmium laser.
Laser lithotripsy is a minimally invasive method of treatment usually requires general anesthesia, but you can go home the same day.
Laser lithotripsy carries a slightly greater risk of complications than extracorporeal shock wave lithotripsy.Nevertheless, holmium laser lithotripsy using a high degree of success and low rate of complications, because the laser energy has no effect on other tissues.
advantages of laser lithotripsy
- Immediate relief
symptoms - In most cases, you can go home the same day
- Rapid recovery with fewer
complications - Suitable for all types of
stones - more than 95% success rate after a single procedure.
Risks and complications of laser lithotripsy
Laser Lithotripsy is usually safe.However, as complications can occur after any medical procedure.The risks associated with laser lithotripsy include:
- Chunks of stone remain in the body.You may need several treatments.
- Bleeding around the kidney, which in rare cases may require a blood transfusion.
- blocking the flow of urine from the kidney due to pieces of stone.If it causes severe pain and blocking of kidney, the stent or drainage tube (fine mesh) may be placed back into the kidney through until all fragments are not yet come out of the kidney and urinary tract.The stent is usually put in the body after laser lithotripsy.