Kidney stones ( nephrolithiasis ) - Causes, Symptoms and Treatment .MF .
stones in the kidneys and should be called "kidney stones" (the informal name of: kidney disease, kidney stones, kidney stone disease, or nephrolithiasis) - polietiologic disease, which is characterized by the formation of stones in the cavity of the pelvis or calyx kidney.
Causes of kidney stones
Because nephrolithiasis is considered polyetiological disease, then allocate multiple reasons, which to some extent contribute to the deposition of stones in the kidney.
Perhaps the most important role in the occurrence of kidney stones plays a metabolic disorder, such as uric acid.A similar pattern is observed with gout, when the concentration of uric acid in urine and blood increases several times.Consequently causes of kidney stones all those conditions must be considered, which lead to the development of gout.The most significant in this list should be considered nutritional factor comprising excessive use of meat, fatty foods, beer and wine.
Increasing the amount of uric acid leads to the formation
Since concretions formed in mochevovodyaschih paths in their development matters more and the state of the mucous membrane.In that situation, because of the infectious diseases, the risk of kidney stones is increased several times when the mucous membrane is damaged renal pelvis, for example.
scheme kidney stones
Symptoms of kidney stones
Symptoms of the disease are directly dependent on the size of calculus.The least severe situation is observed with small stones and the so-called sand.In this situation, the disease can be asymptomatic or manifest slight pain in the kidneys.Typically, the pain is aching, and permanent increases after intense physical exertion or a bumpy ride.In this case, urine may be no change at all or seen a small amount of blood, which is not always possible to identify without a microscope.
more severe clinical symptoms observed when a large amount of stones, and at the close of ureteral lumen.In such a situation develop characteristic symptoms of renal colic.It appears sharp pain in one or both of the kidneys, which are supplemented by nausea, vomiting and significant amount of blood in urine.When obstruction (blockage) concrement both ureters may be a complete absence of urine, called anuria.
Naturally, with such a clinical picture of self is inappropriate and patients immediately turn to the urologist.But in order to prevent the development of such serious symptoms, should be periodically examined by a urologist to determine the presence of stones in the urinary ducts.This will help to quickly identify the disease and seeking treatment for the last time.
diagnosis of kidney stones
In that situation, when the patient comes to the department with an acute attack of renal colic, the doctor on the clinical picture must instantly navigate to proceed immediately to urgent measures.Naturally, in such a situation, the time to conduct additional research is strictly few and limited to only a history and objective examination of the patient.It should be noted that the pattern of renal colic is pretty typical, and often make a diagnosis based on symptoms alone is not too difficult.
In the same situation, when a patient with kidney disease enters the hospital for planned treatment, it is carried out all the necessary range of laboratory and instrumental methods.Perhaps the survey starts with the definition general analysis of blood and urine .Typically, the first is usually normal, while the second one can see different amounts of blood and salt, depending on the stage of disease and the size of calculus.
screening methods in the diagnosis of kidney disease is considered plain radiography of the abdomen and kidney ultrasound .These two methods give the doctor all the necessary information and accurate picture of the structure, the number and position of stones in the kidney cavity.This is extremely important and necessary for the definition of further tactics of the patient.
Radiography.Staghorn kidney stone.
If the X-ray and ultrasound provide accurate information on the number and structure of the stones, they are absolutely not informative in determining kidney function.To do this, it uses a slightly different, but also a simple and inexpensive method of research - excretory urography .The patient is injected intravenously contrast, urine output which then becomes a radiograph abdomen.Contrast, passing through the urinary tract, indicates the status of the lumen of the latter.
In addition to these methods often used computed tomography, which although is more expensive, but gives much more informative data.
to determine the cause of the disease and exclusion comorbidities, some patients carried full blood chemistry , which is indicated by the number of oxalate, urate and phosphate in the blood.
Treatment of kidney stones
Treatment of nephrolithiasis is not shared by the first aid, which is used in renal colic and systemic therapy aimed primarily at preventing relapses.
to apply emergency drugs antispasmodics groups that can be easily purchased at any pharmacy.Such drugs as a no-spa, spazmalgon, baralgin have a relaxing effect on the wall of the ureter, thus contributing to the passage of stone in the bladder cavity.The best effect is observed for intravenous administration of drugs, although some doctors insist on intramuscular.
addition antispasmodics during the acute period of non-drug methods of correction applied, which consist in the appointment of a hot bath and heating pads on the affected area.The mechanism of influence of thermal procedures, about the same as antispasmodics.
Named events can only be considered temporary, since nephrolithiasis has a very strong tendency to relapse.The only true method of getting rid of stones in the kidney is considered to be the removal of the latter.To date, there are several methods of such an operation.
calculi When a large amount of used classic nephrotomy , which is used from the time of Nicholas Pirogov.To date, a large number of proven shortcomings of such an operation, but the stones impressive size, it is simply irreplaceable.
As for current trends in the treatment of kidney stones, at this stage of development of urology the most effective and least traumatic considered ultrasonic lithotripsy .The operation is to use a special apparatus that atomizes ultrasonically kidney stones inside, and then go past with urine.
In inoperable cases, a statement of the stent into the ureter, which serves as a bypass graft, to which incontinence occurs outflow from the kidney to the bladder.But we must remember that this operation is only symptomatic and is not able to cure the patient completely.About once a month the patient requires replacement stent.It should be noted that the procedure is quite unpleasant and painful.
Feeding habits and lifestyle with kidney stones
Nephrolithiasis - one of those pathologies, management and treatment which takes place under strict diet control.In this situation, a 7 table by Pevzner, the main essence of which is to reduce the amount of salt, fatty foods and extractives that contribute to the formation of kidney stones.It is also strictly controlled water regime, to strongly not to load so the affected organ.
disease In case of the operation, patients in need of kidney disease in exactly the same rehabilitation, like the rest of the patients after surgery.In the long term these patients is recommended to visit the special resorts, home of the mineral and mud treatment of nephrolithiasis.Basically, these resorts are located in the highlands, where there are natural sources of mineral water.
Treatment of kidney stones folk remedies
As practice shows, the sick kidney disease resort to folk treatments just before the first episode of colic.Taken as a whole, it may be noted that none of the national treatment schemes which are used for kidney stones, does not give a positive effect in the final result.A variant of exceptions may be considered the use of a decoction of horsetail in the early stages of the formation of stones.
Complications of kidney stones
The most severe complication of kidney disease should be considered as bilateral renal colic.In a situation where it is accompanied by congestion of urine in both kidneys, occurs pathological release metabolic products into the blood.It is accompanied by a deterioration of general condition of the patient and the onset of symptoms of the nervous system.The critical point in the development of renal encephalopathy considered renal coma, which usually ends in death.
no less dangerous complication can be considered as a kidney infection, which is facilitated by the presence of stones.In a similar situation is developing pyelonephritis, which can be complicated by kidney abscess or purulent inflammation of the perinephric fat.
prevent the formation of kidney stones can be used only if the constant stick to a strict diet, to lead an active mobile lifestyle, protects against hypothermia and infections of the genitourinary system.It is worth noting that the deliberate prevention of kidney disease, unfortunately, very rarely performed by patients.As a rule, it applies only in cases where the patient is confirmed by the initial stage of the disease, there is an increased amount of salts in the urine or he had surgery on this occasion.
Ed.urologist Astashin EE