Kidney stones what is it, the causes of its appearance and how to treat it

Kidney stones are a disease of civilization and therefore a tribute to wealth and abundance: overeating, being overweight (obese), alcohol and too much animal protein contribute to this sometimes extremely painful disease. Kidney stones (nephroliths: Greek nephros = kidney, líthos = stone) are crystalline deposits in the kidney.

Most often they are calcium oxalate (70-80%). This is followed by uric acid stones (15-20%), magnesium phosphate stones (10%) and very rarely cystine stones (1%) .The size varies from the size of a pinhead to stones that fill the entire renal pelvis.

Typically, these crystals or stones are removed from the body through urine. Depending on their size and shape, they can also become stuck in the organs and channels of the urinary system and cause pain and medical complications.

Formation of calculi, causes and factors of their occurrence

There are many theories that try to explain the appearance of kidney stones, but they do not reflect the entirety of the process. The most productive research was conducted by two biochemists Lichtwitz and Teid. According to their theory, Kidney stones form when urine can no longer dissolve the calcium salts of uric acid because their concentration is too high. The salts form crystals that become stones. The more the urine is diluted, the lower the risk of kidney stones.

When the composition of urine is disturbed, the ratio of protein crystals and foreign particles (bacteria, fibrin, pus, etc.) rises, destroying the colloidal layer of salt particles, and they begin to stick together. Thus, the core of the future nodule is formed.

This theory explains the appearance of every stone, with the exception of cystine, which is formed by metabolizing amino acids of the same name and increasing its initial concentration in urine.

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In fact, the factors for the occurrence of calculi are very high, and not always the cause is in the urinary tract. Therefore, stones are formed if:

  • Urine stagnates for a long time in the cups of the kidneys. This condition is most common in people with malformations of the ureter and bladder after previous operations on the pelvic organs, where adhesions or nephritis are formed.
  • The ratio of salt and colloids in urine is disturbed.
  • Electrolyte metabolism is impaired (mainly phosphorus-calcium). This is typical for gout, thyroid and parathyroid glands, bone destruction (osteomyelitis, osteoporosis), etc.
  • Uncontrolled or long-term use of medications such as antibiotics, sulfonamides of the glucocorticoid series (prednisolone, dexamethasone), certain types of non-steroidal anti-inflammatory drugs (NSAIDs), etc.
  • Severe dehydration of the body due to heavy, strenuous physical activity, high ambient temperatures, or an illness associated with a large loss of fluid (diarrhea, fever, vomiting)
  • Hypovitaminosis of vitamins A and D.
  • The predominance of meat, protein products in the diet.

    Diagnostics

    Unfortunately, kidney stones do not cause an inflammatory process for the time being, and urine analysis does not indicate their presence. In rare cases, there is back pain during physical exertion and especially when changing the position of the body.

    Concretions are found when there is a complication of the course of the disease. This happens when the stone moves from the kidney to the ureter. It injures the thin mucous membrane, causing blood in the urine and additional bacterial infection.

    The patient undergoes ultrasound of the kidneys and genitourinary system, while the main part of the calculi is found during urography and pyelography.

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    Renal colic

    The worst condition of urinary tract injury is renal colic. This happens when the ureter becomes clogged with a stone and begins to spasm severely, damaging the mucous membrane rich in nerve endings. A person feels incredible, with nothing, incomparable pain, which stops only when taking narcotic analgesics.

    A person cannot find a place for himself in pain. An indirect factor in the onset of renal colic can be prolonged walking, physical activity (lifting weights), riding with shaking, etc.

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    Treatment

    There are three treatment options for the disease:

  • Conservative therapy with herbal remedies, nutritional supplements and a special citrate obligatory diet based on knowledge of the mineralogical composition of nodules. This treatment is applicable only in cases where the stone size does not exceed 2 mm. If the ureter is not closed, so-called conservative procedures that produce a natural release of stones will help: warm baths, compress, up and down movements such as climbing stairs, or jumping, drinking a lot of fluids to flush the stone out of the body.
  • Open surgery. for large kidney stones, the doctor will use the nephrolitholapaxy method, as a result of which he inserts the endoscope through a small skin incision on the flank directly into the kidney, breaks the stones using a laser or ultrasound probe. The fragments are sucked off or washed directly from the kidney. In nephrolitholapaxy, the person usually stays in the hospital for several days.
  • Method of remote stone crushing. approximately 95% of all kidney stones are removed by extracorporeal shock wave lithotripsy. Mechanical shock waves act on the stone from the outside, destroying the kidney stone. Small fragments enter the urine independently from the urinary tract.

    In ureteroscopy, the doctor uses an endoscope, a thin tube with a camera that he can push through the urethra and bladder into the ureter. The brief procedure is performed on an outpatient or inpatient basis under anesthesia.

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    Prevention

    The best prevention of kidney stones treatment is to drink at least 1,5 liters per day. Water, fruit or herbal teas are especially suitable.

    In addition, urinary tract infections need to be treated promptly. The same applies to metabolic, hormonal, renal and gastrointestinal diseases, i.e. diseases that increase the risk of kidney stones.

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    Tatyana Jakowenko

    Editor-in-chief of the Detonic online magazine, cardiologist Yakovenko-Plahotnaya Tatyana. Author of more than 950 scientific articles, including in foreign medical journals. He has been working as a cardiologist in a clinical hospital for over 12 years. He owns modern methods of diagnosis and treatment of cardiovascular diseases and implements them in his professional activities. For example, it uses methods of resuscitation of the heart, decoding of ECG, functional tests, cyclic ergometry and knows echocardiography very well.

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