Stones in urine. Right kidney stone

Experienced urologists know that kidney stones are a disease that often requires surgical intervention. Conservative treatment is not always effective. This pathology otherwise called kidney stone disease, nephrolithiasis. Stones can form not only in this body, but also in the bladder and ureters.

An important body genitourinary system are the kidneys. They are located retroperitoneally. This parenchymal organs, the main functions of which are filtering blood plasma and the formation of primary and secondary urine. If stones are present, kidney function may be impaired. Nephrolithiasis is a polyetiological disease in which stones form in tissues.

They consist of various salts. This pathology occurs in 1–3% of the population. Mostly adults are affected. Bilateral kidney damage occurs in 15% of cases. Men get sick more often. Stones can be single or multiple. Small stones do not exceed 3 mm in size, and large stones reach 15 cm.

Stones initially form in the kidney tissue. With the flow of urine they can descend into the underlying sections. In this case, the patency of the ureters is impaired. This is fraught with acute urinary retention. Kidney stones can cause complications such as pyelonephritis and hydronephrosis. Sometimes complete obstruction of the urinary tract occurs.

Types of kidney stones

The following types of stones are known:

• radiopaque;
• X-ray negative;
• poor radiopacity.

Depending on the composition, the following types of stones are distinguished:

• oxalate;
• phosphate;
• urate;
• carbonate;
• protein;
• cystine;
• cholesterol;
• xanthine;
• coral-shaped;
• struvite.

Each of them has its own distinctive features. Oxalate stones are the most commonly formed stones. They are detected in 70% of sick people. These stones have the following distinctive features:

• formed by salts of oxalic acid;
• practically insoluble;
• have a spiky surface;
• dark brown or black;
• often injure tissue;
• most often formed in an acidic environment;
• dense.

These kidney stones can appear in people who abuse fresh juices, citrus fruits, chocolate, baked goods, tomatoes and herbs. Often found phosphate stones. They consist of crystals of phosphoric acid. Their distinctive features are white or grey colour, soft consistency and round shape. They crumble well.

The optimal environment for their formation is urine with a pH above 6.2. These stones occur predominantly in women. In 10% of cases, urates are detected. These are stones that are formed by uric acid salts. Urates are dense, light yellow or Brown, with a smooth surface. Formed in an acidic environment.

They are not visible on an x-ray. Urates are often formed in people suffering from gout. Less commonly, carbonate stones form in the kidney tissue. They are formed by salts of carbonic acid. They various shapes, smooth and light. In 1–2% of cases, cystine stones are detected. They contain the amino acid cystine. Such stones are quickly dissolved by medications.

Coral stones are often found in the area of ​​the renal pelvis. They have a bizarre shape and sharp edges. Women sometimes develop struvite (infectious) stones. They contain ammonium phosphate. These stones are different rapid growth. They are easily destroyed by lithotripsy.

Pathogenesis of disease development

Nephrolithiasis right kidney and the left develops gradually. It is based difficult process. First, a micelle is formed in the organ tissue. The following components act as building materials:

• salt;
• cell debris;
• fibrin threads;
• foreign bodies;
• urine sediment.

Most often, the renal papillae are initially involved in the process. Microliths form in the collecting ducts (tubules). Normally, they are not deposited in tissues, but are released along with urine. When the pH of urine changes, they are retained. Crystallization processes occur. The papillae are encrusted. The stones are growing. Initially they are about 4 mm, but under favorable conditions the stones reach 5–10 cm or more. Very often they are carried away with the flow of urine.

Risk factors for the development of nephrolithiasis

The appearance of large and small stones in the kidneys is associated with several factors. The basis is the crystallization of urine rich in salts. Predisposing factors are the following:

• monotonous nature of nutrition;
• excess of certain foods in the diet;
• genetic predisposition;
• violation mineral metabolism;
• increased sweat production;
• hot climate;
• drinking water with lime salts;
• abuse spicy dishes and pickles;
• excessive synthesis of parathyroid hormone;
• leaching of calcium from bones;
• osteoporosis;
• fractures;
• osteomyelitis;
• long-term immobilization;
• impaired bladder emptying;
• ureteral reflux;
• gastritis;
• peptic ulcer;
• hydronephrosis.

Very often, nephrolithiasis develops against the background of dystopia. This is a congenital pathology in which changes normal location one or both kidneys. Nephrolithiasis develops in people suffering from dehydration. The reason lies in the lack of fluid, against the background of which salts are not washed out of the body, but settle in the kidneys.

The nature of your diet is of great importance. The mineral composition of foods (vegetables, fruits, berries, herbs) largely depends on the nature of the soil. Stones often form if meat, offal, spinach and peas are present in the diet every day. Predisposing factors are lack ultraviolet rays, lack of vitamin D, monotonous lifestyle, harmful working conditions and physical fatigue.

Signs of kidney stones

You need to know not only the reasons for the formation of stones, what they are, but also how nephrolithiasis manifests itself. This disease causes the following symptoms:

• pain in lumbar region on one or both sides;
• passage of stones in urine;
• headache;
• chills;
• fever;
• weakness.

There is a change in urine parameters. It contains salts, pus and blood. A common sign is hematuria. It occurs when there are stones with sharp edges. The latter damage blood vessels. With gross hematuria, the urine becomes red or pink due to a large number of red blood cells.

The most common symptom of nephrolithiasis is pain. It's aching or dull. The pain syndrome is caused by difficulty in the outflow of urine. In severe cases, renal colic occurs. This symptom is represented by acute, paroxysmal pain in the lower back. It radiates to the perineum and genitals. Colic causes flatulence, nausea and vomiting. Mictions become painful.

Kidney stones can cause decreased daily urine output or acute delay urine. In case of joining bacterial infection pyuria occurs. This disease is characterized by the appearance of pus in the urine. Normally it is not there. The disease often occurs in a chronic form. Exacerbation can be caused by physical exertion, hypothermia, bumpy driving, injuries and other factors.

Methods for detecting stones

Before treating a sick person, it is necessary to ensure that the diagnosis is correct. The following studies help detect stones:

• survey urography;
• pyelography;
• radioisotope nephroscintigraphy;
• CT scan;
• Magnetic resonance imaging.

This is what a kidney stone looks like on ultrasound examination

Additionally, urine and blood tests are performed. If necessary, a biochemical study is organized. A general urine test reveals the following changes:

• hematuria;
• presence of protein;
• salt;
• bacteria.

The most informative is computed tomography. It allows you to determine the exact location of stones, their density and shape. Most available method diagnostics - urography. In case of pain on the right side, it is imperative to exclude acute surgical pathology(appendicitis, cholecystitis).

How to get rid of stones

The main goals of treatment are the following:

• removal (dissolution) of stones;
• prevention of dangerous complications;
• normalization of urine outflow;
• elimination of infection;
• warning re-education stones.

Every attending physician should know how to provide care to patients. If the stones cause an attack of colic, thermal procedures are required. This could be a sitz bath with hot water or a heating pad. Antispasmodics (Spazmalgon, Drotaverine) are prescribed. They relax the muscles of the ureters, thereby facilitating the passage of stones.

Treatment includes taking painkillers. For small stones (several millimeters), drinking plenty of fluids is recommended. With the development of pyelonephritis, antibiotics and uroantiseptics (nitrofurans) are prescribed. Diuretics are often included in the treatment regimen. For some types of stones, drugs that dissolve them can be used.

This group includes Uralit-U, Purinol, Allopurinol-Egis and Blemaren. Uralit-U is effective for uric acid and cystine stones. Allopurinol is used to treat patients with calcium oxalate stones. If the right or left kidney is affected by stones, herbal tea is prescribed. Good effect renders Prolit.

It is possible to carry out physical procedures (dynamic amplipulse therapy, magnetic therapy, electrical stimulation). To prevent relapses, you need to adhere to proper nutrition and stay hydrated. drinking regime. Mineral water is selected for each patient, depending on the type of stones.

Relaxation in a sanatorium is recommended. With urate stones, red wine, beer, offal, mushrooms, legumes and meat are excluded from the diet. It is recommended to eat cereals, fruits, berries, vegetables, cottage cheese, eggs, pasta and dairy products. If you have oxalate stones, limit your consumption of coffee, greens, jellies, beans, beets, beef, carrots, sauerkraut, citrus fruits, tomatoes, sorrel and currants.

If phosphates are detected, then you need to eat less salt, currants, lingonberries, dairy products, cheese, cottage cheese, as well as all vegetables and fruits. The most effective is radical treatment. External lithotripsy, dissection of the pelvis, nephrolithotomy or kidney removal are performed.

Methods for preventing nephrolithiasis

Surgery (lithotripsy) does not protect against relapse of the disease. To prevent them, you need to adhere to the following recommendations:

Kidney stones are dense formations that form during internal cavity organs at kidney stone disease(nephrolithiasis).

Their number can range from 1-2 units to several hundred, and their size varies from 1-3 mm to 15 cm in diameter. Most often, stones are diagnosed in men, but women and children are also susceptible to their accumulation.

How are stones formed?

The process of stone formation is associated with metabolic disorders and transformation of tissues of the urinary system.

As a result, substances that should be “flushed” from the body are retained in the kidney tubules.

We are talking about foreign bodies, salts, sediment, bacteria, fibrin threads, and so on. From them micelles are formed - the nuclei of future stones.

Subsequently, with a pathological change in the properties of urine, crystals begin to accumulate around the nuclei, which gradually turn into stones that differ in shape, size and composition.

Types of stones

Depending on the chemical formula, there are several types kidney stones:

• oxalate - dense, dark, with spikes on the surface, consisting of calcium salts of oxalic acid;
• phosphate - loose, white-gray, contain calcium salts of phosphoric acid, have a tendency to grow rapidly;
• carbonate – soft, smooth, brown, formed from calcium salts and carbonic acid;
• urate - strong, yellow or brown, with smooth edges, consisting of uric acid salts;
• protein – flat, loose, small, white, are formed from fibrin, salts and bacteria;
• cystine - soft, smooth, contain sulfur compounds of cystine;
• cholesterol - fragile, black, composed of cholesterol;
• xanthine - very strong, formed from ammonium urate;
• struvite - white, easily broken, formed as a result of the accumulation of carbonates, phosphates, ammonium and magnesium, have the ability to rapidly increase during infectious diseases.

The most common stones are oxalate, phosphate and mixed stones, less often - xanthine, cystine and cholesterol.

Struvite accumulations are considered the most dangerous - in a short period of time they can occupy almost the entire kidney cavity, that is, turn into coral stones.

Causes of nephrolithiasis

Nephrolithiasis is caused by various factors affecting the composition of urine and its excretion. The main causes of stone formation are:

Kidney stone disease is very often hereditary. People whose close relatives have experienced it should carefully monitor their diet and lifestyle, as well as regularly undergo urological examinations.

Symptoms

Small single stones in the kidneys without concomitant diseases most often they do not show themselves at all.

With average and large size stones, a person may notice an unpleasant aching sensation in the lumbar region, which intensifies if the accumulations begin to move.

As they move, the stones can clog the urinary tract, causing renal colic.

Its symptoms:

• unbearable pain in the lower back, radiating to the genitals;
• increased urge and discomfort during urination;
• nausea, vomiting, flatulence.

In some cases, there is a decrease in the amount of urine or complete absence, as well as an increase in temperature. Often after an attack, stones are passed out along with the urine. If they have sharp spines, blood may appear in the discharge (hematuria).

Nephrolithiasis greatly increases the likelihood of developing pyelonephritis - inflammation of the kidney tissue. Its accession is indicated by such signs as:

• severe pain in the lower back;
• fever, weakness;
• impurities of pus in the urine, changes in its color and smell.

In addition to pyelonephritis and colic, kidney stones can lead to a number of serious complications - hydronephrosis, nephrosclerosis and chronic renal failure.

Diagnostics

The following methods are used to diagnose nephrolithiasis:

1. History taking, palpation.
2. Laboratory research:
   • urine analysis and urinary samples - detects blood, bacteria, salts, protein and increased level leukocytes;
   • clinical and biochemical blood tests - allow you to assess the general condition of the body and possible causes of stone formation;
3. Instrumental techniques:

• survey and/or excretory radiography genitourinary organs– makes it possible to detect stones, as well as establish their size, shape and location;
• Ultrasound of the kidneys, bladder, ureters and other organs abdominal cavity– necessary to exclude other pathologies similar in symptoms to kidney stones;
• scintigraphy, CT, MRI - are performed in case of a complex clinical picture.

Wide list diagnostic measures necessary for precise definition specific characteristics of stones. Based on the research results, effective treatment is prescribed.

Among surgical methods for treating kidney stones, doctors are increasingly resorting to the least traumatic extracorporeal lithotripsy. Here you will learn all about this and other methods of removing kidney stones.

Treatment

Conservative therapy

Kidney stones up to 3-5 mm in diameter very often pass on their own. To facilitate their “washing out”, diuretic herbs and diet are prescribed. Its type depends on the type of stones:

• with urate - a dairy-vegetable diet is required;
• phosphate - consumption of cheese, fish, milk is prohibited;
• oxalate - exclude vegetables and fruits with oxalic and ascorbic acids, limited to meat and offal.

Medicines that dissolve stones - Cyston, Rovatinex, Prolit and others - may be prescribed. They act best on urate formations, but oxalates practically do not respond to such therapy.

If nephrolithiasis is accompanied by an infection, then treatment with antibiotics is mandatory. Severe pain is an indication for taking antispasmodics.

During an attack of renal colic, the patient is given an injection of a strong analgesic. In addition, it is recommended that he sit in a warm bath or apply a heating pad to his lower back.

Operative methods

Removal of stones is indicated for:

• repeated pyelonephritis;
• frequent colic;
• hydronephrosis;
• large formations;
• severe hematuria.

In most cases, a remote lithotripsy procedure is performed - ultrasonic rays are sent through the skin to the stones, which destroy them. Small fragments are gradually released along with urine.

If this method cannot be implemented, they resort to laparoscopic or full-fledged surgery - the stone is removed by dissecting the kidney tissue. After removal, the patient is advised to continue following a diet.

Under no circumstances should you attempt to remove stones on your own using medications or folk remedies. This may lead to acute renal colic and chronic failure.

Kidney stones are a serious pathology that does not manifest itself in any way at the initial stages. To reduce the risk of their formation, it is necessary to consume a sufficient amount of fluid, eat a balanced diet and promptly treat all diseases of the genitourinary system and gastrointestinal tract. After stone removal, you should adhere to a certain diet, as well as regularly use urological herbal medicines.

Video on the topic

February 18, 2017 Doctor

When the properties of urine are disturbed, stagnation processes in the kidneys or bladder begin the development of urolithiasis, in which stones form, scientifically they are called calculi. Kidney stones are dense formations that can have different chemical compositions, sizes and shapes. This pathological process begins with the appearance of microliths - crystals or grains of sand, which, gradually increasing in size, turn into stones.

Causes of urolithiasis

As a rule, several reasons become the starting point for the development of urolithiasis, that is, the formation of formations in the kidneys. This may be due to both internal and external factors. Quite often, the main cause is genetic predisposition. In such cases, the problem occurs in several members of the same family in more than one generation.

The essence of the formation process is that salts, normally dissolved in urine, under certain conditions precipitate.

Such conditions may include too much concentration of certain substances or a change in the composition of the urine, resulting in the formation of solid particles. Each such particle disrupts the normal movement of urine and, as it were, attracts other crystals. That is, first small stones form in the kidneys, which gradually increase in size.

Factors of stone formation

• Unfavorable environmental background.
• Unbalanced diet.
• Violations metabolic processes, at which the concentration of individual salts in the body increases.
• Congenital anomalies of the urinary system.
• Diseases that cause urinary stagnation.
• Urinary system infections.
• Dehydration of the body.

With a genetic predisposition, exposure to even one of these factors quite quickly leads to stone formation. Men are more often susceptible to this pathology, which is due to their anatomical features. IN male body The urinary tract is longer and narrower, so slower outflow or stagnation of urine occurs much more quickly, which leads to a pathological process.

Manifestations of urolithiasis

Small stones in the kidneys in the absence of an inflammatory process may not be felt at all for a long time. This means that there is a high probability of developing quite large stones. Symptoms appear when they begin to compress tissues and blood vessels, and also when they enter the ureter or bladder, that is, exit the kidneys.

Symptoms of urolithiasis

• Periodic dull pain in the lower back.
• Changes in urine.
• Increased fatigue.

If an infection occurs, for example, pyelonephritis, then symptoms characteristic of the inflammatory process are added:

• temperature increase;
• headache;
• nausea;
• increased lower back pain;
• hematuria is possible.

The most striking manifestations occur during renal colic. This is a condition where a stone passes out of the kidney and ends up in the urinary tract.

Stones in the bladder injure the mucous membranes of the bladder itself, as well as the ureter through which they move. Even a small ureteral calculus, when advancing, can cause a severe attack of renal colic. The pain is so severe that the person simply cannot find a place for himself; even delirium and clouding of consciousness are possible due to painful shock. The temperature rises, nausea appears, vomiting is possible, and blood is almost always present in the urine. All these symptoms are caused by urinary retention, inflammation, pressure on nerve endings and injury to the walls. urinary tract.

A concretion of the right ureter when advancing always causes more strong manifestations than the left. When stones move from the left kidney, the symptoms may resemble myocardial infarction, as they are often accompanied by chest pain, arrhythmia, and general weakness.

Diagnosis of stones

Several procedures are necessary for diagnosis. Because the symptoms of urolithiasis and other kidney diseases are similar, careful and accurate diagnosis is required. Another problem is the similarity of the manifestations of left-sided stones with a heart attack, and right-sided ones with appendicitis or problems with the gallbladder and liver. Only an accurate diagnosis will allow you to prescribe the correct treatment.

Diagnostic procedures

1. Kidney ultrasound is the most common, accessible and quite informative technique.
2. CT scan– a study that allows you to most accurately determine the size and location of stones and identify even the smallest ones.
3. Laboratory tests are necessary to detail the clinical picture and assess the patient’s condition.

The primary detection of formations in the kidneys occurs during ultrasound. This is noted in the diagnostic results, which are necessary for the doctor to make a diagnosis and prescribe treatment. Left-sided urolithiasis is not as severe and painful as right-sided one.

If a right kidney calculus is detected, this means that there is a microlith or stone in the right kidney, and it is necessary to find out its nature in order to take timely measures.

If necessary, diagnosis can be supplemented with contrast radiography, MRI, radioisotope scintigraphy. A study of urine and blood shows the nature of the stones, the condition of the kidneys and the entire body. To reveal infectious process, a urine microflora analysis is done.

What to do

The first question that arises if stones are identified is how to treat the pathology. For small stones, conservative therapy may be effective, but the patient should not rely solely on medications. He will have to follow a drinking and eating regime and carefully follow all the doctor’s recommendations. Drug therapy designed to relieve symptoms, eliminate inflammation and ensure the passage or dissolution of kidney stones.

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Medicines for urolithiasis

• Diuretics.
• Anti-inflammatory.
• Antispasmodic.
• Dissolving stones.
• Accelerating the passage of stones.

Under no circumstances should you prescribe any of these drugs to yourself, because the consequences can be very negative. For example, improper use of diuretics can “force” the stone to move, leading to renal colic.

If the patient has large stones, treatment will consist of surgical removal or crushing using ultrasound or laser technology.

An obligatory part of treatment for urolithiasis is following a diet that matches the type of stones. Drinking regimen is also important, because a sufficient amount of liquid helps dissolve salts and prevents stone formation.

And a little about secrets...

Painful urination, acute pain in the lower back, cloudy urine!? All these symptoms indicate the appearance of kidney stones. Ignoring diseases of the kidneys and urinary system as a whole can lead to the most dire consequences.

Now answer the question: are you satisfied with this? Can problems be tolerated? How much money have you already spent on ineffective treatment? Perhaps it is more correct to treat not the effect, but the cause? That's right - it's time to end this! Do you agree? That is why we decided to publish a link to advice Elena Malysheva: "How to get rid of kidney stones without the help of doctors, at home?!"

Kidneys are one of the most important organs human body. If disturbances occur in its work, this negatively affects the body as a whole. One of the most serious kidney pathologies is the formation of stones and the development of kidney stones (nephrolithiasis), one of the forms of urolithiasis.

"Concretion" in Latin means "accretion." It is a dense formation or stone that is formed from sediment of mineral substances. Stones can form in people of any age and gender if they are created for this purpose. favorable conditions. Nephrolithiasis can lead to serious consequences and complete loss of kidney function.

Education mechanism

There is no exact answer to what exactly triggers the formation of stones. According to research, they can be formed due to complex chemical and physical processes, which are caused by changes in the equilibrium of colloids and renal parenchyma. The basis for the formation of stones can be salts, bacteria, and foreign bodies.

The main component of stones are urine salts. Urine is a kind of saline solution. Chemical compounds do not dissolve in water, in order to be evenly distributed in the urine, they combine with different proteins, forming complexes. This balance may not always be constant. Any change in the concentration of compounds in urine, its acidity level, or the presence of impurities lead to the destruction of complexes and create the preconditions for the formation of stones.

Salts precipitate and their crystallization begins. The core of the stone is formed. Gradually new crystalloids and colloids join it. According to this theory, all types of stones are formed this way, except cystines. It is believed that they are formed due to precipitation when the concentration in the urine is exceeded. This pathology occurs in people with congenital cystinuria.

Types of deposits

Based on the chemical composition of the formations, they are divided into several types:

• - are formed by calcium compounds and oxalic acid. They have a dense structure, a sharp, uneven surface.
• Phosphates - consist of calcium salts of phosphoric acid. Their surface is smooth and their shapes can be varied. Due to their soft structure, phosphates are easy to crush.
• - formed from uric acid salts. They are hard and have a smooth surface. Can be dissolved when taking medications.

Less common are cystine, xanthine, protein, and cholesterol stones. Absolutely homogeneous stones are practically never found. Classification is carried out based on which compound is greater.

Causes of kidney stones

The process of formation of kidney stones can be influenced by various factors, both congenital and acquired. TO congenital causes may be attributed to genetic predisposition or geographical factors (hot climate).

Acquired reasons:

• chronic and infectious diseases Gastrointestinal tract, genitourinary area;
• disorders of electrolyte metabolism that are associated with diseases parathyroid gland, gout, osteomyelitis, bone destruction;
• lack of fluid intake;
• unhealthy diet (abuse of salty, fried, spicy foods);
• deficiency of vitamins A, D;
• impaired urinary outflow due to narrowing of the urinary tract, adhesions, tumors;
• long-term use of certain medications (Aspirin, Tetracycline, Biseptol).

First signs and symptoms

Go to the address and read the information about the reasons acute glomerulonephritis kidneys in children and methods of treating the disease.

Surgery

The most effective method The only treatment for nephrolithiasis today is surgery. The choice of surgical intervention method will depend on the size of the stone, its location and access.

The following types of surgical treatment of deposits are used:

• Extracorporeal lithotripsy- crushing formations using a special device using ultrasonic, laser and other types of waves. The operation does not require skin incision and is performed remotely.
• Contact lithotripsy- carried out using an endoscope. The instrument is inserted from the lower part of the ureter into the bladder, then to the immediate location of the stone. Crushing is carried out by exposure to certain shock waves.
• Open surgical removal- carried out in cases where the stones have reached an impressive size and the location of the deposits does not make it possible to remove them in any other way.

Prevention measures

If a person has a tendency to deposit salts and form stones, you need to take preventive measures to minimize the possibility of this process.

• increase the amount of fluid consumed so as not to create a high concentration of salts in the urine;
• follow the rules dietary nutrition, limit the consumption of foods that promote stone formation;
• adjust exchange and hormonal disorders in organism;
• to refuse from bad habits;
• promptly treat chronic diseases and inflammatory processes of the urinary organs;
• regularly undergo tests to monitor health status paired organ.

Kidney stones are a serious pathology. If the disease is not treated, serious complications may follow. The sooner deposits are detected, the higher the chance of getting rid of them painlessly. Even complete removal kidney stones does not guarantee that they will not appear again. It is better to eliminate all prerequisites for this in advance and focus on prevention. At the slightest suspicion of kidney failure, you should consult a nephrologist or urologist and undergo a full examination.

Nephrolithiasis is the most common urological diseases, manifested by the deposition of stones in the kidneys. Video is a fragment of the TV show “About the Most Important Thing” about the causes, treatment features and consequences of deposits in a paired organ:

Kidney stones can occur in people of any age, but the problem most often occurs in adults. Stones of different sizes can lead to a complete cessation of urine outflow, which will cause hydronephrotic transformation. Timely treatment will help prevent dangerous complications and save a person from the disease.

How are they formed

The process of kidney stone formation consists of several stages. First, a matrix or framework for the future stone is formed, consisting of protein compounds, blood cells and renal epithelium. Then, gradually, chemical compounds of minerals and acidic residues begin to be deposited on this base, which are constantly excreted through the kidneys. In fact, the formation of stones in the kidney is such a gradual and slow layering of salt compounds on the matrix base, which ensures the growth of the stone to large sizes. Occupying the entire pelvicalyceal space, the staghorn calculus becomes a serious problem for human health.

According to statistics, right kidney stones are more common. Bilateral damage occurs in almost every 5 people suffering from kidney stones (20%).

Risk factors

The formation of stones is promoted by external and internal factors, which ensure the formation of a matrix and facilitate the process of layered salt deposition.

• features of drinking water and eating behavior when mineral compounds of calcium, sodium and phosphorus enter the blood in large quantities;
• climate features (lack of sun or constant heat, high humidity or excessive dryness);
• lack of vitamins;
• toxic effect on the kidneys.

• diseases of the parathyroid glands;
• congenital or acquired disorder of mineral metabolism;
• problems with the gastrointestinal tract;
• chronic inflammation in the urinary tract;
• creating conditions for stagnation during urinary excretion.

Kidney stones always occur as a result of a combination of several factors, the main of which will be inflammation, stagnation and any variant of impaired mineral-salt metabolism. Therefore, the course of treatment is usually complex. It is necessary to create conditions to improve outflow, remove inflammation and restore the balance of mineral metabolism.

Separation of stones by size

When identifying kidney stones, it is very important to assess their number and size. Multiple fine sand (the size of each grain of sand is up to 1 mm) is best option for treatment. It is enough to change your diet, start drinking special mineral water, and the risk of stone formation will disappear.

It is more difficult to choose treatment when detecting single or multiple microliths, the size of which does not reach 10 mm. Considering that the ureter leaving the kidney has a diameter of 6–8 mm, spontaneous passage of these stones can be expected. However, the risk of an attack of renal colic due to the fact that several small kidney stones get stuck somewhere in the ureter is quite high. Therefore, one must be extremely careful in approaching any methods of removing kidney stones if the estimated size of at least a few of them exceeds 8 mm.

If stones larger than 10 mm are detected that cannot move into the ureter and spontaneously pass, it is required individual approach to treatment. Large kidney stones larger than 100 mm are removed surgically.

Treatment methods

The main types of treatment for kidney stones are:

For bilateral disease, the choice of treatment option depends on the size of the stone and the risk of complications. With macroliths on the left and multiple microliths on the right, surgical intervention is performed in stages: first, the stone in the left kidney must be removed, and after 2–3 months, stones in the right kidney can be addressed. A one-time operation is performed extremely rarely due to the high risk of renal failure.

Kidney stone formation is complex and gradual chemical process happening in the background associated factors and the obligatory accumulation of salt residues in the urine. The treatment option for nephrolithiasis is always selected individually. The chances of avoiding surgery largely depend on the size of the stones.

Pochkimed.ru

Kidney stones: what are they?

Kidney stones are a fairly common disease of the urinary system. Patients of any age can get it, and treatment is a long process that requires great patience. Next we will talk about kidney stones, what they are, the general characteristics of kidney stones, and we will also consider treatment methods.

In general, kidney stones occur when the body experiences a disruption of colloidal balance and changes in the renal parenchyma. The building material for stones can be fibrin threads, amorphous urine sediments, foreign bodies, cellular detritus, bacteria and salts.

The process of stone formation occurs gradually. First, due to metabolic disorders, sand and tiny stones appear in the collecting ducts, which doctors call microliths. In most cases, people do not notice their presence, and these formations are excreted through urine. However, against the background of other diseases, unbalanced nutrition, hereditary predisposition, congenital pathology of the urinary system, microliths in the kidneys may be retained. In this case, excess undesirable substances in the urine will be layered on the microlith, gradually turning it into a kidney stone.

Types of stones

Kidney stones are divided into types according to various criteria - by number, size, shape, but the most important, in the context of treating the disease, is the chemical division.

Below we offer you a brief overview of the most common stones.

Oxalates are formed from oxalic acid salts under conditions of alkaline or acidic urine reaction. Externally, oxatals are black or gray crystals of a dense structure with sharp edges, sometimes spiky in shape.

Urates are formed from uric acid salts under acidic urine conditions. Externally, urates look like smooth, brick-colored hard crystals.

Phosphates - are formed from the calcium salt of phosphoric acid under conditions alkaline reaction urine, often occur against the background of pyelonephritis. Externally, they are smooth, white or light gray stones of a soft structure.

Carbonates are formed from calcium salts of carbonic acid. Externally they are light, smooth, soft stones of the most varied shapes.

Protein stones are formed from fibrin and bacteria mixed with salts. Externally, these are small, white stones of a soft structure.

Cystines - are formed from sulfur compounds cystine in people with hereditary disorder absorption of cystine and diaminomonocarboxylic acids. Externally, these are yellowish-white, smooth, soft stones, mainly round shape.

Cholesterol stones are fragile, black formations that are “not visible” to x-rays. They are extremely rare.

Today doctors name a lot of factors possible occurrence kidney stones. Conventionally, these factors can be divided into external and internal. Internal include: congenital pathologies of the urinary system, diseases digestive system, liver, as well as genital organs, hyperparathyroidism.

External factors for the formation of kidney stones include all possible factors that are not associated with hereditary and congenital pathologies of the urinary system. These, in particular, include: nutritional habits, geochemical conditions, climate, etc. Very important, at the same time, have the conditions external environment where the patient lives: air temperature, humidity, quality of drinking water, soil composition, local flora and fauna, as well as nutritional habits.

The main symptoms of kidney stones include: impaired urination, cloudiness, darkening and blood in the urine, lower back pain, increased body temperature, etc.

But the main symptom that indicates the presence of stones in the patient’s urinary system is renal colic. It occurs when a calculus clogs the pelvis or ureter. In this case, extremely strong, sharp, cramp-like pain occurs, often radiating to the genitals, limbs, and back.

Typically, an attack of renal colic lasts from an hour to two, after which there is a lull. After an attack, stones can often be found in the urine, as well as blood from wounds in the mucous membrane that occurred when the stone came out.

In some cases, the very strong paroxysmal nature of the pain confuses doctors and renal colic is mistaken for attacks of pancreatitis, cholecystitis or appendicitis. To establish correct diagnosis In addition to the medical history and typical symptoms, laboratory and instrumental studies are required.

Left kidney

When asked “what is a left kidney stone?”, only one answer arises – it is a stone located on the left side of this paired organ. It may not manifest itself in any way until it begins to move towards the bladder. In very rare cases, the presence solid formation will clearly appear on the left. Most likely, it will even be pain behind the sternum and under the “spoon”, signs of arrhythmia and rapid heartbeat, as well as complete weakness.

Right kidney

A more common occurrence is a right kidney stone. It manifests itself somewhat more intensely and most often as renal colic, severe pain radiating to the lower limbs and groin elevated temperature, vomiting, nausea and almost always blood in the urine.

Small calculus of the left or right kidney

On initial stage a small calculus appears in the left kidney (or right), and in some cases in two at once. While they have not been identified, because initially there are no signs of their presence, they gradually increase and slowly begin to “harm” the functionality of the organ. If a person is regularly examined, this will speed up the identification of the threat and the prevention of its consequences. At this stage, it is enough for the patient to increase his water intake in order to naturally “cleanse” the kidneys and determine together with the doctor suitable diet based on the composition of the pebbles.

Laboratory research

• general analysis blood – shows whether this is happening in the patient’s body inflammatory process;
• biochemical blood test - shows whether there is a metabolic disorder in the patient’s body;
• general urinalysis - shows the presence of red blood cells, leukocytes, salt crystals, bacteria in the urine;
• biochemical urine analysis - determines the presence of salts and amino acids in the urine;
• various urine tests.

Instrumental studies

In order for the general characteristics of kidney stones to be correct and the treatment methods to be prescribed correctly, the patient needs to undergo an examination. Instrumental diagnostics includes: ultrasound examination of the kidneys, plain and contrast radiography, computed tomography and magnetic resonance imaging, as well as radionuclide examination.

Most often in domestic medicine, ultrasound and radiographic research methods are used due to their accessibility, but at the same time, sufficient information content. In most cases, these methods are sufficient to determine the location, size, shape of stones, and changes in the structure of the kidneys. Only in cases where this is not possible, for example, a doctor is dealing with stones that are “invisible” to x-rays, other, more expensive equipment is used for diagnosis.

Treatment of kidney stones

Only a specialist from the urology department decides how to treat kidney stones.

To treat kidney stones, two types of treatment are used - traditional and surgical.

Efforts traditional treatment are aimed at dissolving kidney stones and removing them from the body in a natural way. To do this, the urologist prescribes to the patient medications, puts together a special diet, and herbal medicines are often prescribed to enhance the effect of medications.

When preparing a diet for a patient, the doctor starts from chemical composition stones available in urinary system patient. The main task of such a diet is to stop the accumulation of “building material” for stones in the kidneys.

If traditional therapy doesn't work, the doctor uses surgical methods interventions.

Traditional Operations to remove kidney stones these days they are used extremely rarely, since they have a lot of side effects and often cause complications. Lithotripsy is becoming increasingly popular in the treatment of kidney stones. This is the crushing of kidney stones using various types energy. Today in medical practice they use various methods crushing stones - ultrasonic, laser, pneumatic, remote.

Renal colic is treated symptomatically by administering antispasmodics to the patient, and extreme cases- narcotic analgesics and novocaine nerve plexus blockers.

Visual video about stone crushing

The administration of the portal categorically does not recommend self-medication and advises consulting a doctor at the first symptoms of the disease. Our portal presents the best medical specialists with whom you can make an appointment online or by phone. You can choose the right doctor yourself or we will select one for you absolutely free. Also, only when you make an appointment through us, the price for a consultation will be lower than in the clinic itself. This is our little gift for our visitors. Be healthy!

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medportal.net

Kidney stones - a symptom or a disease?

During normal functioning of the urinary system, small crystals formed in the kidney structures are excreted in the urine. Disruption of the filtration processes in the pelvis and calyces of the kidneys leads to the enlargement of these chemical compounds and the formation of stones from them. The formation of stones is not only a symptom of a pathology that causes a violation of the dynamic balance biological fluids. Constantly growing, kidney stones can provoke another serious disease - kidney stones, or nephrolithiasis.

Mechanism of stone formation

Human urine consists of water and salts dissolved in it, the main cations of which are chlorides, sulfates, and phosphates. The kidneys take an important part in metabolism, so urine contains protein breakdown products: uric acid and its compounds. The elements that form the solid part of urine enter into various chemical reactions with each other, the product of which is tiny crystals.

Such a saturated solution serves as a favorable environment for solid particles to precipitate, but with an active filtration process, all of them are removed from the body through urination. If the dynamic balance is disturbed under the influence negative factor, the following processes occur:

• The content of protein threads in the urine, which prevent the enlargement of crystals, is reduced.
• Content increases pathological mucus or pus, which, despite their protein origin, provoke the clumping of particles.
• The resulting crystal becomes the basis of the future stone.

Such a nucleus can be formed from foreign bodies, bacteria, cheesy urinary sediment, the protein thread itself, and chemical compounds. The process begins to develop at the apices of the left or right renal pyramids, and the collecting ducts serve as a site for the accumulation of crystalline formations. The surface tension of the microlite is increased; it attracts molecules of chemical compounds and protein components of urine. Over time, small and large stones are deposited on the walls of the papillae, which gradually move down towards the bladder.

Kidney stones can come in a variety of sizes

Why do stones form in the kidneys?

Concretions are formed under the influence of one or several factors at once. One of them is the person's age. As the body ages, the elasticity of blood vessels and muscles decreases, and urination processes slow down. Therefore, the concentration of salts and metabolic products in urine increases, provoking an enhanced crystallization process.

Stones may appear for the following reasons:

Coral kidney stones

• The presence of an inflammatory process in the human body various localizations. Under the influence of pathogenic microorganisms, an infectious focus appears and a large amount of pus is released, accelerating the formation of stones. A severe complication of cystitis, glomerulonephritis, pyelonephritis is always urolithiasis.
• Acquired or congenital pathologies occurring with metabolic disorders. Most common cause the occurrence of stones is a malfunction endocrine glands and decreased or increased hormone production. The salt content in urine increases with gout, osteoporosis, and hyperthyroidism.
• Pathologies of the digestive system change the composition of urine - chronic gastritis, gastric ulcer, pancreatitis.
• Long-term use pharmacological drugs can affect the composition of urine: antibiotics, aspirin, antitumor agents.

Drinking unfiltered water also leads to the formation of kidney stones, as it contains a large amount of salts. Doctors diagnose kidney stones in adherents monotonous diet, mostly protein origin. Fans of salty and peppery foods are at risk - an increase in the concentration of salts in the urine leads to the loss of crystals.

Also identified by experts hereditary predisposition to increased crystallization with the formation of stones.

Every nephrologist has a wonderful collection of stones of all kinds and sizes. They were removed from the patient’s body during surgery or they came out naturally when urinating. Concretions differ from each other in shape, size and chemical composition. These are the main types of stones:

• Cholesterol stones: coal-black, easily broken.
• Oxalates: gray, heterogeneous, dense.
• Cystine: yellowish, soft, very smooth.
• Urates: durable, yellow or red.
• Phosphates: soft, smooth, silvery.
• Carbonates: gray, smooth, without roughness.
• Stones containing protein: snow-white, heterogeneous, soft.

Typically, each stone contains several chemical ingredients. Stones are classified according to the main chemical compound that has the highest concentration in the stone.

Kidney stones injure the mucous membranes of the ureters and cause bleeding

Symptoms of nephrolithiasis

Small kidney stones with a soft porous structure (phosphate or cholesterol) long time do not cause any symptoms. In the presence of larger and harder stones, a person feels nagging pain in the lower back, which worsen with physical activity and heavy lifting. The pain can be localized in one area of ​​the body, but more often spreads throughout the back, radiating to groin area.

The clinical picture changes with the beginning of the movement of stones from the left or right kidney towards the bladder. Passing through narrow vessels, a hard calculus injures the mucous membranes, and sometimes violates the integrity of the natural canals. Damage or rupture of blood vessels is directly indicated by the appearance of blood in the urine. If the urine has changed color, and every time you urinate, blood clots are found in it, then an inflammatory process has begun in the deformed area.

The following signs indicate the formation of one or more stones in both kidneys:

• Decreased volume of urine excreted.
• Cutting pains when urinating.
• The appearance of edema of various localizations.

When moving, a large calculus can completely block one of the urinary tracts, causing renal colic. Symptoms of the disease appear immediately:

• Acute pain occurs in the lumbar region.
• The person begins to urinate more often, while experiencing painful spasms.
• Digestive upset occurs: vomiting with large discharge of bile, heartburn, diarrhea.

For availability infectious focus indicate pain at the end of urination, urinary leakage and incontinence, hyperthermia followed by chills, insomnia, apathy.

This is what kidney stones look like on an ultrasound machine screen

Diagnosis of kidney stones

Diagnosis begins with examination of the patient: assessment of the general condition and palpation to determine the area of ​​localization pain. After listening to complaints and determining the presence or absence of chronic diseases, the doctor will write a referral for tests. To identify stones, urine results are important: with nephrolithiasis, the content of uric acid and salts in it increases.

When the organs of the urinary system are infected with pathogenic viruses or bacteria, the content of leukocytes, products of protein metabolism and microorganisms in urine is increased.

results laboratory analysis blood tests will help assess the state of health of a person and indirectly determine the cause of the formation of stones. To exclude pathologies, following procedures examinations:

• Computed tomography of the pelvic organs with introduction radioactive isotopes.
• Magnetic resonance imaging with or without contrast.
• Ultrasonography condition of the kidneys, ureters, bladder.

Using ultrasound, you can visualize stones, their location and guess the chemical composition. It is important to accurately determine the area where the stones are located - this will be the basis further treatment.

Often, a stone can only be removed from the kidney through surgery.

If the size of the stones in the human body does not exceed 4 mm, then they are able to leave the body on their own. A stone of this diameter moves through the vessels without destroying or injuring them. For better passage Herbal diuretics are recommended for patients:

• Corn silk.
• Bear ears.
• Lingonberry leaf.
• Erva is woolly.
• Orthosiphon staminate.

Pharmacological drugs with a selection medicinal herbs Cyston and Canephron are able to dissolve and painlessly remove kidney stones. It is very important not to use these products for self-treatment.

People who abuse diuretics often end up in hospital beds. With increased urination, a large stone began to move, injuring blood vessels and provoking renal colic.

A special diet, individual for each type, will help dissolve the stones:

• Milk and vegetables for urats.
• Cereals and vegetables for oxalates.
• Lean meat and carbohydrates for phosphates.

If an infectious focus is detected, antibiotic therapy with cephalosporins is used. Stones larger than 4 mm are destroyed using ultrasound, and extracorporeal lithotripsy is performed. Small portions of the stones are then gradually passed out of the body with each urination. If the found stone is large, hard, and not amenable to ultrasound, invasive intervention is performed to remove it.

There are excellent techniques for cleansing the kidneys of accumulated sand and toxins. They can be used to prevent the formation of crystalline compounds with further enlargement. Proper nutrition, physical activity and the absence of bad habits also do not contribute to stone formation.

2pochki.com

General characteristics of kidney stones and treatment methods

Kidney stones are a manifestation of urolithiasis. Stones can appear in both adults and children.

The process of stone formation

Urolithiasis develops as a result of complex physicochemical processes occurring due to a violation of colloid balance and changes in the renal parenchyma. Under the influence of a number of factors, a so-called micelle is formed from molecules, which serves as the core of the future stone. The material for the formation of a calculus can be fibrin threads, amorphous urine sediments, foreign bodies, cellular detritus, bacteria and salts.

Most often, the formation of stones begins in the renal papillae. First, microliths appear in the collecting ducts, most of them are freely excreted in the urine. With some changes in the chemical properties of urine (pH shift, high concentration salts, violation of their ratio) a crystallization process occurs, as a result of which microlites are retained in the kidney, encrusting the papillae. Over time, the stone may increase in size or move into the underlying urinary tract.

Types of stones

Depending on the chemical composition, the following types of kidney stones are distinguished:

• oxalate,
• urate,
• phosphate,
• carbonate,
• protein,
• cystine,
• xanthine,
• cholesterol

1. Oxalate stones consist primarily of oxalic acid salts. They have a dense consistency, an uneven spiky surface and a grayish-black color. Oxalates can be formed from both alkaline and acidic urine reactions.
2. Urate stones are formed by salts of uric acid. The color of urate stones ranges from yellow to red, the surface is smooth, and the consistency is quite dense. Urates appear with acidic urine.
3. Phosphate stones consist of a calcium salt of phosphoric acid. They have a soft consistency, smooth surface, light gray color, and crumble easily. Phosphates are formed in the kidneys during the alkaline reaction of urine and grow quickly. Often occur against the background of pyelonephritis.
4. Carbonates are formed when calcium salts of carbonic acid are present in urine sediment. Such stones may have different shapes, they are soft, smooth and light.
5. Protein calculi consist mainly of fibrin and bacteria with an admixture of salts. Their consistency is soft and their color is white. Typically, protein stones are small in size.
6. Cystine stones are formed from sulfur compounds of cystine and have soft structure, smooth surface, yellowish-white color, usually round in shape.
7. Cholesterol stones are rare. They are composed of cholesterol, are black in color and crumble easily.

Causes of kidney stones

Many factors play a role in the formation of kidney stones:

• changes in salt content (for internal or external reasons),
• hot climatic conditions,
• drinking regime,
• composition of food consumed,
• infectious diseases of the urinary system,
• poisoning,
• various diseases leading to disorders of mineral metabolism (hyperparathyroidism, osteoporosis, osteomyelitis, trauma spinal cord, gastritis, gastric ulcer or duodenum, liver failure and etc.),
• genetic predisposition (familial cases of nephrolithiasis occur).

Stones in the kidneys

Recommendation: if one of your relatives suffers from urolithiasis, this may indicate the hereditary nature of the disease. For early detection stones, it is necessary to undergo regular examination in the form of a general urine test, ultrasound of the kidneys and bladder.

Symptoms of kidney stones

1. pain in the lumbar region,
2. hematuria,
3. renal colic,
4. In some cases, stones may be passed in the urine.

Dull aching pain in the lower back is caused by a violation of the outflow of urine. If a calculus clogs the pelvis or ureter, renal colic develops. It is characterized by sharp, paroxysmal pain in the lower back and along the ureter. Renal colic may be accompanied high temperature body, motor restlessness, nausea and vomiting, flatulence.

Oliguria or anuria may develop against the background of pain. Pain during colic can be so severe and acute that it is relieved only with the introduction of narcotic analgesics. After the attack ends, stones or sand may pass out in the urine.

Renal colic must be differentiated from diseases accompanied by acute pain. A right kidney stone can cause symptoms similar to those of acute cholecystitis, adnexitis or appendicitis. Left-sided colic sometimes its manifestations resemble acute myocardial infarction, complications of gastric ulcer.

Diagnosis of kidney stones

The diagnosis is made based on the medical history, typical symptoms, as well as laboratory and instrumental examination methods. Upon examination and palpation, a positive Pasternatsky symptom and pain in the area of ​​the kidneys and ureters are revealed.

Laboratory research

• general urine analysis (presence of hematuria, leukocyturia, bacteria, salts and protein),
• general blood test (detection of inflammatory changes in the blood indicating infection),
• biochemical research blood and urine (used to determine possible reasons stone formation and approximate composition of stones),
• various urine tests.

Instrumental methods

Ultrasound of the kidneys, ureters, bladder and other abdominal organs is used to exclude diseases with similar clinical presentations. The main diagnostic method is x-ray examination: survey and excretory urography, pyelography. With their help, it is possible to determine the location, size, shape of stones, and changes in the structure of the kidneys. It should be kept in mind that on plain radiograph urate stones are not visible because they allow X-rays. Sometimes radioisotope renal scintigraphy, CT or MRI are performed.

Treatment of kidney stones

Treatment is aimed at removing kidney stones. It can be conservative and operative. If the stones are small, then water load and a special diet are used to remove them with urine. The diet menu depends on the composition of the stones. There are also preparations for dissolving stones different composition. Depending on the symptoms and complications, antibiotics, antispasmodics, diuretics and other drugs may be prescribed.

For renal colic, it is necessary to administer strong analgesics and antispasmodics; sometimes they resort to novocaine blockade of the nerve plexuses. A stone from the ureter can be removed endoscopically using a catheter. Sometimes large stones are removed surgically. Online access depends on whether the stone in the left or right kidney occurs in this case, as well as the level of its location. IN Lately The method of extracorporeal lithotripsy is increasingly being used. In this case, the stones are crushed into smaller ones and removed independently.

Important: you cannot remove or dissolve stones yourself. This can lead to the development of serious complications in the form of hydronephrosis, chronic renal failure, pyelonephritis, stone strangulation, etc. Only a doctor can prescribe necessary examination and treatment depending on the composition, size and shape of the stones.