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Nephrolithiasis – a recurring problem

Nephrolithiasis – a recurring problem
Nephrolithiasis is caused by the precipitation of insoluble deposits into the urinary tract. Knowing the composition of the deposits helps to determine the cause of urolithiasis and allows for specific treatment. Stones are most often formed in the calyx and renal pelvis, the movement of the stone down the urinary tract causes a characteristic pain – renal colic. About 50% of kidney stones are recurrent.

Kamica nerkowa: lekarz pokazuje na Pani, gdzie boli podczas kamicy nerkowej

How is renal colic manifested?

  • Symptoms of renal colic include:
  • Renal colic – pain in the lumbar region, radiating to the pubic symphysis, genitals and the inner surface of the thighs. Pain in the area of ​​the kidney on which the stones are located increases with the examination of the Goldflam symptom (shaking the kidney area with a fist, gently striking the hand against the body).
  • Nausea and vomiting
  • Pressing to urinate with frequent urination in small amounts
  • Fever and chills (especially present in urinary tract infections)
  • Hematuria (rare).

 

Where does kidney stones come from?

The origin of nephrolithiasis varies. The most common cause of precipitation is excessive levels of calcium oxalate in the urine. Stone precipitation can also be caused by an infection in the urinary tract.
The precipitation of lithogenic substances into the urine is predisposed by:

  • Primary hyperparathyroidism
  • Metabolic acidosis
  • Chronic diarrhea
  • Enzymatic defects
  • Urinary tract infection
  • Tumor
  • Diet

A diet that reduces the risk of the problem should meet the conditions of a low-fat and low-oxalate diet. One should also pay attention to the optimal supply of calcium in food and limitation of sodium intake.
Due to the high concentration of oxalate, avoided foods should be: spinach, rhubarb, soybeans, nuts, chocolate, strong coffee or tea, excess meat.
The habitual intake of vitamin C predisposes to the formation of kidney (oxalate) stones. It is recommended not to exceed the dose of 1500 mg of vitamin C daily in order to reduce the risk of kidney stones.

Establishing an optimal diet requires determining the composition of the kidney stone.

 

Complications of kidney stones

Nephrolithiasis is a disease whose consequences, unfortunately, are not limited only to the symptoms characteristic of urolithiasis. The most common complications of prolonged obstruction or narrowing of the urinary tract by calculus are hydronephrosis and urinary tract infection.
Hydronephrosis is a condition caused by a reduced outflow of urine from the renal pelvis. Collecting in the kidney, urine causes the tissues of the organ to stretch dangerously. The consequence of hydronephrosis can be damage to the interstitial tissue, as well as to the glomeruli. Damage to the functioning of the kidneys due to hydronephrosis leads to consequences that are dangerous for other organs. One of the more serious complications is hypertension resulting from insufficiently functional kidneys.
Urinary tract infection, which is a consequence of urolithiasis, results in symptoms related to the infection and aggravates the urolithiasis problem itself. The presence of bacteria in the urinary tract is associated with the so-called struvite. Struvite is a material that can participate in the formation of kidney stones. The problem of secondary infection to urolithiasis can therefore aggravate the problem of urolithiasis. Urinary tract infection is also associated with symptoms such as fever, severe pain, and difficulty passing urine. The consequence of infection, in extreme cases, may be sepsis.
The serious health effects of kidney stones make it imperative to start as soon as possible when a problem is detected …

… Treat kidney stones

Treatment of kidney stones is based on the introduction of habits such as avoiding eating foods that worsen the problem, drinking sufficient water and administering medications appropriate to the composition of the stone.
Treatment of an acute attack of renal colic is achieved by administering anti-inflammatory drugs, opioid drugs, and drugs that relax smooth muscles. Emergency treatment of colic must be performed in a hospital setting due to the method of drug administration (intravenous administration is preferred).
Invasive nephrolithiasis treatment techniques are used especially when there is a risk of damage to the urinary tract by plaque. The stones can be broken by sound waves, with a transurethral catheter, with an endoscope, or with surgery.
The doctor is responsible for selecting the appropriate methods of invasive and pharmacological treatment. Treatment should also be determined in cooperation on the doctor-patient level, because each treatment method has its own strengths and limitations.
Suspicion of kidney stones should be consulted with a doctor.

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