Kidney stone also called nephrolithiasis is a kidney stone disease. The term is derived from the Greek words “nephros” – kidney, “lithos” – stone. The disease most often makes itself felt with renal colic – the most obvious for diagnosis and sensitive symptom for the patient. Nephrolithiasis is caused by the formation of stones in the renal pelvis and calyces. This pathology, to one degree or another, occurs in 7 out of 10 people. Sooner or later, they will be faced with the need for medical care to get rid of severe pain and fear of the unknown.
- Nephrolithiasis symptoms.
- Causes of nephrolithiasis.
- Diagnosis of nephrolithiasis.
- Lithotripsy – surgery for nephrolithiasis.
- Litholysis – dissolution of stones in nephrolithiasis.
- Pain reliever for nephrolithiasis.
- Diet for nephrolithiasis.
The first symptoms of the disease are acute pain on the side of the abdomen and in the lower back, which penetrates a person so strongly and suddenly that the doctor has to use narcotic pain medications to relieve it. The patient cannot ease his position, he takes various postures, from which it does not get any easier. The pain radiates to the genitals, thighs, groin and pubis.
Additional symptoms of nephrolithiasis:
- Nausea and vomiting;
- Frequent urination.
These symptoms are caused by a stone that has started to move from the kidney and is stuck in the ureter. Small stones are more likely to be the culprit of intense pain than stones of impressive size. The movement of the stone is provoked by driving on a shaky road, physical activity.
If a large coral-shaped stone began to move, a dull pain of an unsharp nature is felt. Pain is caused by the stone getting in the way of urine flow.
The nature of the sensations makes it possible to find out the location of the stone, its size and even its composition. After an attack of colic, some of the stones leave without any additional manipulations along with the urine. If there is an admixture of blood in the urine, it means that the stone has damaged the mucous membrane of the urinary tract on its way. Oxalates almost always have sharp edges and injure the ureters. Phosphates are conglomerates with a smooth surface that cause less damage.
The location of the stone in the ureter or in the renal pelvis responds with acute pain in the groin, in the lower part of the ureter – the pain radiates to the genitals.
Almost always, patients with nephrolithiasis suffer from pyelonephritis. Its main symptoms are:
- Arterial hypertension;
- Pyuria is a purulent discharge in the urine.
In about 13% of patients with kidney stones, the nature of the pain is moderate, it is tolerated quite easily, and small stones come out unnoticed. Possible complications of this variant of the development of the disease are kidney infection. Bacterial infection eventually turns into hydronephrosis – persistent atrophy of the tissues of the kidney calyces and renal pelvis.
Complications of the chronic form of the disease:
- Symptomatic hypertension;
- Chronic renal failure.
Causes of Nephrolithiasis
The main cause of urolithiasis is urination disorders, changes in the composition of urine. Regions endemic in terms of the frequency of detection of nephrolithiasis have dietary habits and a different composition of drinking water from the norm.
Additional causes of nephrolithiasis:
- Urinary tract infection;
- Narrowing of the ureter;
- Kinked ureter.
Staying in a hot climate with dry air leads to the development of the disease faster than being in a region with cold and humid weather conditions.
Types of Stones – Provoking Factors:
- Urates – consist of uric acid salts, are more often formed by those who prefer meat to other products;
- Phosphates – consist of calcium salts of phosphoric acid, found in vegetarians and those who prefer dairy products with a high calcium content, mainly milk;
- Cystine stones – associated with liver disorders;
- Oxalate stones;
- Xanthine stones;
- Carbonate stones;
- Mixed stones – contain salts of different compositions;
- Soft stones are elastic formations consisting of protein: fibrin, amyloid, bacteria.
The stones range in size from a grain of sand to an egg-sized formation. Urates and phosphates grow slowly and infrequently grow larger than the nut. Phosphates and carbonates grow rapidly to create high volume coral stones. They fill the entire renal pelvis or its calyx, creating an impression of this organ.
If the urologist or nephrologist knows the composition of the stone, they can more accurately prescribe treatment, convey to the patient the importance of careful treatment and follow-up recommendations.
You may also like to read - Cholesterol: Symptoms, Causes and Best Methods to Lower Cholesterol Level.
Diagnosis of Nephrolithiasis
Since the patient suffers unbearable pain during renal colic, he will definitely seek medical advice. The nephrologist will carry out obligatory diagnostics, including laboratory and instrumental examination methods.
Diagnostics of the kidney stone disease:
- Study of the anamnesis.
- Analysis of the symptoms of pathology according to the patient.
- Analysis of urine.
Urinary tract X-ray is the main method for detecting hard conglomerates, not suitable for detecting soft stones that transmit X-rays.
Ultrasound of the kidneys and ureters – allows you to detect formations of at least 3 mm in size, during the study there is a risk of accepting a large stone with sharp edges for a few small stones, and a coral-like formation for several large stones.
Excretory urography is used to clarify the location of stones, the state of all parts of the urinary system and their functioning.
Computed tomography is the most accurate diagnostic method.
Lithotripsy – Surgery for Nephrolithiasis
You should not refuse surgical treatment if there are good reasons for it. Lithotripsy – crushing stones with a special apparatus that directs a shock wave to a point on the body, determined by a doctor. The patient is in the water in a semi-sitting position.
Indications for surgery for kidney stones:
- Repeated attacks of renal colic;
- Complications of pyelonephritis in history;
- A significant amount of stones with a narrowed ureter;
- Absence of one kidney;
- Disruption of kidney function after an attack for a week;
- Lack of stone shift within 3 months.
It is possible that those with indications will lead to the need for a serious and traumatic surgical operation.
Litholysis – Dissolution of Stones in Nephrolithiasis
For effective dissolution of stones, it is desirable that the urine pH is between 6.2 and 6.8. Preparing for the course of litholysis, the patient within a week measures the pH of urine with a special indicator paper, a street graph for presentation to the doctor. Based on these measurements, the nephrologist determines the doses of drugs and the timing of their use. It is advisable to drink the alkaline mineral water Borjomi, Truskavets, Essentuki instead of drinks during the preparation for the litholysis of urate stones.
Preparations for preparing a mixture that dissolves urates:
- Lemon acid;
- Sodium citrate;
- Potassium citrate;
- Magnesium citrate;
- Magnesium citrate;
- Magurlite (pyridoxine hydrochloric acid).
Preparation Trilon B is used to dissolve phosphates. Preparing for the litholysis of phosphate stones, it is recommended to take the mineral water.
Pain Reliever for Nephrolithiasis
Acute pain during an attack of renal colic is relieved by antispasmodics and drugs with analgesic properties (1-2 tablets):
Knowing for sure that the cause of renal colic is urolithiasis, you can put a hot heating pad on your lower back, or take a bath with a water temperature of +45 °C. If there are doubts about the source of the pain, thermal procedures should not be taken in order to avoid serious consequences. Such colic can be a manifestation of other diseases in which the effect of heat is dangerous. If the above remedies do not work, the emergency doctor will relieve the pain by injecting a strong pain reliever.
Diet for Nephrolithiasis
With an increased content of uric acid salts and its crystals in the urine, it is necessary to limit meat and fish products in the diet to 150 gm per day. The method of cooking meat and fish dishes is boiling in water or steam.
With an increased risk of phosphate formation, dairy products, egg yolks, and potatoes are excluded from the diet.
The formation of oxalates is a reason for removing pepper, sorrel, spinach, salad from the menu, and limiting milk, meat, carrots and potatoes.
For the prevention of recurrence of urolithiasis after surgery or after independent stone release, medications are used:
- Madder dye extract,
- Phytopreparations with antispasmodic action.
These methods will improve blood circulation and lymph flow in the kidney, salt metabolism in the blood. It is advisable to regularly visit a doctor for specific recommendations and take a urine test.