Fri. Aug 12th, 2022
    Kidney Stone

    Kidney Stone

    The terms renal stone, nephrolithiasis, renal lithiasis, kidney stones and the old name “stone disease” refer to the formation of a piece of solid material composed of calcium or uric phosphate salts and carbonate, inside the kidney from substances that are in the urine.

    Causes

    Origin of kidney stones and other stones

    Our body needs minerals and trace elements. Their role is important for the constitution of tissues, for the regulation of water exchanges in our body, a good functioning of the brain, or even the assimilation of nutrients.
    The calculus or lithiasis is a cluster of crystals which forms as a result of too high a concentration of these mineral elements.

    The most common are gallstones (or gallbladder stones) and kidney stones (kidney stones). When the stones are very small, we speak of microlithiasis.

    The evacuation of the crystals thus formed, depending on their size and nature, sometimes goes unnoticed, but can be very painful, or impossible, requiring surgery.

    Symptoms of kidney stones

    When the stones migrate outward from the kidney, there are two forms of lithiasis disease.
    – Painful migration, over a few hours or a few days: this is the crisis of renal colic, medically monitored and treated.

    – Slow migration, without pain or discomfort, sometimes lumbar attacks, or pain in the flank, sometimes just a few burning during urination.

    How to stop kidney stone pain immediately

    Treatment of the attack always begins with anti-inflammatory drugs (Ibuprofen, Paracetamol..). If the pain is severe, the doctor injects the drug intramuscularly or, better yet, intravenously. And if that’s not enough, doctor may adds a little morphine. In most cases, this treatment, continued for a few days, gradually relieves the pain, and the stone eventually goes down. The patient can eat and drink normally.

    Food to avoid

    Persons who have a tendency to form calcium oxalate stones should reduce the following oxalate-rich foods:

    • Beets
    • Chocolate
    • Coffee
    • Coke
    • Nuts
    • Rhubarb
    • Spinach
    • Strawberries
    • Tea (black and to a lesser extent also greener)
    • Wheat bran

    In order to prevent cystine stones, a lot of water must be drunk, which reduces the cystine concentration in the urine. To do this, more than three liters of water must be drunk daily, one third of it at night.

    Herbal medicine

    Kidney stones should be able to be dissolving with the help of tea from real rennet herb. Likewise, a tea infusion of dandelion roots should help transport the stones. Real cat beard or orthosphon relaxes the dissipating urinary vessels, acts against inflammation by kidney stones and thus reduces overall pain in outgoing stones. Serologically, a drop in serum nitrogen levels can be observed. Good results are also possible with ordinary inflammation of the kidney due to delayed bladder catarrhoea.

    Screening / examination

    It is during a medical examination, often an ultrasound, that urolithiasis is discovered.

    Examinations are then possible to determine their size and locate them:
    – ultrasound

    – classical X-ray: for stones that are opaque and visible on X-rays (except uric acid stones which are transparent)

    – urography: radio using X-rays and a contrast product to identify stones

    – the abdominal scanner without injection remains the safest and the Gold Standard, it detects opaque or transparent stones.

    – a biological assessment comprising:

    – a bacteriological examination to detect a possible infection,

    – a blood test for creatinine to study the functioning of the kidneys,

    – a spectophotometric analysis of the calculations for the evolution and the possibilities of treatment

    – a phospho-calcium balance to determine the mineral levels, the volume of urine over 24 hours, the urine pH and the clarity of the urine in the morning to suggest dietary measures or medical treatments.

    Treatment of kidney stones and prevention

    In the event that there is no renal colic, two possibilities for treating stones:

    Curative treatment with destruction by extracorporeal route:
    – the bursting of urolithiasis by shock waves

    – ureteroscopy (rigid or flexible): a miniaturized endoscopic device is introduced by natural means to fragment the calculus by laser

    – percutaneous surgery for too large stones

    Preventive treatment:

    – increase the daily water ration (for at least 2 liters of urine / day), and adopt appropriate dietary rules

    – regularly perform ultrasounds or x-rays to monitor the expulsion of stones.

    Operation: when, how, for whom?

    If there are signs of a urinary tract infection associated with a stone, or if you have only one kidney, urgent surgical treatment will be undertaken. It will consist in allowing the evacuation of urine either by natural means, with the installation of a probe most often between the kidneys and the bladder (JJ probe or endoureteral prosthesis), or by the installation of a probe connecting the kidney directly to the skin (nephrostomy).

    Apart from renal colic, the treatment of the calculus may call for a surgical technique. The choice of technique will depend on the type of calculation, its size, its location and the number of calculations. Some techniques require either loco-regional or general anesthesia. The main techniques are:

    • Extracorporeal lithotripsy (ESL), which consists of a device sending shock waves to fragment the stone to allow its evacuation.
    • Ureteroscopy or ureterorenoscopy, which consists in passing through the natural ways, to introduce an endoscope (urethoscope) to fragment then proceed to the ablation of the stones.
    • Percutaneous nephrolithotomy, which involves puncturing the renal cavities with a fine needle, passing either through the back or the side, then creating a tunnel in order to introduce a nephroscope to treat the stones.
    • Conventional surgery known as open or by laparoscopy, of exceptional indication.

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    Information: Cleverly Smart is not a substitute for a doctor. Always consult a doctor to treat your health condition.


    Sources: PinterPandai, Mayo Clinic, American Kidney Fund, NHS UK, Urology Care Foundation

    Main photo credit: Apurv013 / Wikimedia Commons (CC0)