Urolithiasis disease

Urolithiasis disease (уролитиаз) – заболевание, возникающее в
the result of metabolic disorders, in which the urine is formed
insoluble sediment in the form of sand (up to 1 mm in diameter) or stones
(from 1 mm to 25 mm and more). Камни  оседают в мочевыводящих
pathways that disrupt the normal flow of urine and cause
the occurrence of renal colic and inflammation.

What is the cause of urolithiasis, which are the first
signs and symptoms in adults, and what is prescribed as
treatment, consider next.

What is urolithiasis?

Urolithiasis disease

Urolithiasis disease — это заболевание, характеризующееся
appearance in the urinary organs (kidneys, ureters,
bladder) solid stone-like formations. Inherently
urinary stones are crystals that originate from salts,
dissolved in urine.

Concretions in urolithiasis may be localized as in
right and left kidney. 15-30% of patients have
double-sided stones. Clinic for urolithiasis is determined
the presence or absence of violations of urodynamics, changes in renal
functions and affiliated infectious process in
urinary tract.

ATиды мочевых камней:

  • Ураты — камни, состоящие из солей мочевой кислоты,
    yellow brown, sometimes brick-colored with smooth or slightly
    rough surface, rather dense. Formed during acidic
    urine reactions.
  • Фосфаты — конкременты, состоящие из солей фосфорной
    acid, greyish or white, unstable, easily broken,
    often combined with infection. Formed in alkaline urine.
  • Оксалаты — состоят из кальциевых солей щавелевой кислоты,
    usually dark, almost black with a spiky surface,
    very dense. Formed in alkaline urine.
  • Редко встречаются цистиновые, ксантиновые, холестериновые
    concretions.
  • Смешанные камни — самый распространенный вид
    concretions.

Causes

This disease is polyetiologic, that is, to its
development leads to several factors. Most often urolithiasis
the disease develops in people aged 20–45 years, with men
suffer from it 2.5-3 times more often than women.

Urolithiasis disease развивается, чаще всего, из-за нарушения
metabolism. But here it is necessary to take into account the fact that urolithiasis is not
будет развиваться, если для этого нет предрасполагающих
factors.

The causes of urolithiasis are as follows:

  • diseases of the kidneys and urinary system;
  • metabolic disorders and diseases associated with it;
  • pathological processes of bone tissue;
  • dehydration;
  • chronic diseases of the digestive tract;
  • unhealthy diet, excessive consumption of junk food –
    spicy, salty, sour, fast food;
  • acute lack of vitamins and minerals.

Stones with urolithiasis can form in any
отделе urinary tract. AT зависимости от того, где они
are, distinguish the following forms of the disease:

  • Nephrolithiasis in the kidneys;
  • Ureterolithiasis – in the ureters;
  • Cystolithiasis – in the bladder.

Symptoms of urolithiasis

The first signs of urolithiasis are found either
by chance, during the examination, or during a sudden
renal colic. Renal colic – severe painful attack, often
which is the main symptom of urolithiasis, and sometimes
the only one that results from a spasm of the urinary duct,
or its obstruction by stone.

ATедущие симптомы мочекаменной болезни, или на что жалуются
Patients:

  • жжение и резь над лобком и в мочеиспускательном канале при
    urination – due to spontaneous emergence of small
    pebbles, the so-called “sand”;
  • low back pain associated with a sharp change in body position,
    shake violently, drink plenty of water (especially after drinking
    liquids such as beer and brines). Pains are due to
    slight displacement of stones;
  • hyperthermia (high temperature) – indicates
    severe inflammatory reaction to the stone at the place of its contact with
    mucous membranes, as well as the accession of infectious
    complications;
  • Renal colic. When blockage of the ureter stone pressure
    in the renal pelvis rises sharply. Stretching the pelvis in the wall
    which is a large number of pain receptors, causes
    severe pain Stones less than 0.6 cm in size, as a rule, depart
    on their own. With narrowing of the urinary tract and large stones
    The obstruction does not spontaneously disappear and may cause
    damage and death of the kidney.
  • Hematuria. In 92% of patients with urolithiasis after
    renal colic is marked microhematuria, resulting from
    damage to the veins of the fornical plexus and detected during
    laboratory research.

And the size of the calculus is not always comparable to the severity
complaints: the largest stones (coral stone) can
for a long time not to disturb a person, whereas relatively
a small calculus in the ureter leads to renal colic with
severe pain manifestations.

Clinical manifestations depend primarily on localization
stone and the presence or absence of inflammatory process.

Signs of urolithiasis with localization in different
departments

Localization of stones Symptoms
Bladder The severity of the area:

  • one of the subcostal
  • crotch,
  • нижней части живота и половых органов

Frequent and difficult urination, which is accompanied by
by sharp

  • Urine cloudiness
  • Blood in the urine
Ureter Sensation that the bladder is not completely emptied. Pain in
area of ​​the genitals, thighs and groin
zone of the abdomen, which can give in the crotch and lower
Extremities Nausea prone to repeated vomiting
Kidney
  • Dull pain in upper lumbar region
  • Presence of blood in the urine

With the development of the pathological process can be observed
such signs of urolithiasis:

  • unstable blood pressure;
  • increased body temperature, sometimes up to 40 degrees;
  • симптомы почечной колики;
  • frequent urination that does not bring
    relief;
  • pain in the lumbar region, sometimes on both sides;
  • blood in the urine;
  • pain when urinating.

Complications

Common complications of urolithiasis:

  • Chronic inflammation in the area of ​​the calculus,
    выраженное пиелонефритом, уретритом или циститом, которые
    against the background of negative influences (viral diseases, hypothermia)
    go into acute form.
  • Chronic pyelonephritis that progresses rapidly to
    renal failure.
  • Acute inflammation of the kidneys can be aggravated by paranephritis with
    the appearance of pustular organ tissue lesions. AT дальнейшем
    probable abscess and blood poisoning, which is a direct indication
    to surgical intervention.
  • Ishuria, or acute urinary retention.
  • Pyonephrosis is a serious complication of purulent pyelonephritis,
    characterized by the destruction and melting of kidney tissue.
  • Anemia occurs as a result of permanent blood loss from
    hematuria.

Diagnostics

If you suspect urolithiasis, you must first contact
to the therapist who will conduct the initial examination of the patient.
If stones are found in the kidneys, the patient will be sent to
nephrologist, if in the bladder – to the urologist. AT лечении участвует
a dietitian and also often require prompt
intervention.

Diagnostics мочекаменной болезни основывается на следующих
data:

  • Characteristic complaints of the patient to recurrent back pain,
    bouts of renal colic, urination disorders.
  • General and biochemical analyzes of urine and blood.
  • Ultrasound.
  • Excretory urography (introduction of a contrast into the blood,
    which is excreted in the urine unchanged).
  • Retrograde pyelography (introduction of contrast in the direction,
    reverse flow of urine through the urethra). Produced rarely and strict
    indications.
  • Special blood tests for parathyroid hormone and
    calcitonin, calcium and magnesium salts, determination of blood pH.
  • CT scan.

From what stones are formed in the kidneys with urolithiasis
disease, will depend on the selection of treatment. In order to determine
type of stone, it is enough to pass the tests:

  • анализ крови на кальций (ионизированный и
    общий), фосфор, магний, мочевую кислоту;
  • общий анализ мочи;
  • biochemical analysis of daily urine for urates, oxalates, calcium
    and phosphorus;
  • stone spectral analysis – gives the most accurate information about
    its composition.

Based on the research results, the doctor will determine which type of
salts prevails and what is the stone.

Treatment

Both operational methods of treatment and
conservative therapy. Tactics of treatment is determined by the urologist in
depending on the age and general condition of the patient, localization and
the size of the stone, the clinical course of urolithiasis, the presence
anatomical or physiological changes and renal stage
failure.

General principles of treatment of urolithiasis:

  1. Drink plenty of water. Whatever the reason 
    the emergence of ICD, concentrated urine contributes 
    the formation of new stones or the “growth” of existing ones. AT случае
    Nephrolithiasis recommended at least 2 liters of fluid for
    days.
  2. Diet. AT зависимости от характера рН и преобладающих солей
    prescribed a diet that promotes the dissolution of small stones. Diet
    питания может или ускорять их  растворение, или способствовать
    their formation and recurrence of ICD even after the stone is released.
  3. Physical activity. Immobility, sedentary lifestyle
    provoke the occurrence of stones, and walking, running, jumping – removing
    microliths.
  4. Фитотерапия: мочегонные, противовоспалительные травы.
  5. Удаление камня (хирургическими и консервативными
    methods).

Medications for urolithiasis:

  • Anti-inflammatory: indomethacin, ibuprofen, acetomenophen,
    ketorolac;
  • Antibacterial: cilastatin, gentamicin, amikacin,
    ceftriaxone, gatifloxacin;
  • Antispasmodics: drotaverine, mebeverin, otiponiya bromide;
  • Analgesics: voltaren, revodin, diclomax;
  • Diuretic: furosemide, aldactone, veroshpiron
  • ATитамины: группы AT.

Operation

Indications for surgery for urolithiasis:

  • large sizes of stones when they cannot be crushed and
    withdraw without surgery;
  • significant impaired renal function, while the rest
    treatment methods in this case are contraindicated;
  • the position of the stone: if it is inside the kidney, its very
    difficult to crush and take out;
  • purulent process in the kidneys (purulent
    pyelonephritis).

Types of surgery:

  • Endoscopic removal of stones from the bladder and end
    Department of the ureter.
  • Laparoscopic kidney or ureter surgery.
  • Extended open kidney surgery (performed upon
    large kidney stone when resection is required or
    removal).
  • Lithotripsy. Destruction of stone focused
    electro-hydraulic wave. The destroyed calculus is displayed with
    urine in the form of sand.

Diet

Depending on the type of urinary formations and identified exchange
violations by the doctor prescribed nutrition for urolithiasis. AT
The whole diet for urolithiasis includes:

  • increase fluid intake (at least 2 liters per day);
  • decrease in volume of portions;
  • increase in dietary foods rich in fiber;
  • restriction of salt intake, spices;
  • restriction of the use of food and drinks with stone-forming
    properties (animal protein, purines, oxalic acid, etc.).

What can not eat with different types of urolithiasis?

Nutrition for kidney disease will depend on the composition
stones, and therefore may include mutually exclusive products.
Calcium is the basis of most urinary stones. Celebrated
the highest prevalence of calcium stones (among which
calcium oxalate and calcium phosphate), urate, consisting of
uric acid salts and magnesium-containing. Main role in
the formation of calcium oxalate plays a glut of urine with calcium and
oxalate.

Лечебная диета при отложении оксалатных камней
provides an exception to the power supply:

  • green lettuce, spinach, sorrel, rhubarb, beets, celery,
    parsley;
  • chocolate, cocoa;
  • jelly and jellies;
  • figs and portulaca;
  • vitamin C as a dietary supplement, as well as products where
    vitamin is a preservative;
  • smoked meat, salinity and pickles;
  • broths and spices;
  • offal.

Запрещенные продукты при отложении уратных камней:

  • canned marinades;
  • fish and meat of adult animals (you can eat three times a week not
    fatty varieties in boiled form), veal and
    mutton;
  • sausages and smoked meats;
  • offal (brain, liver, lungs);
  • salted cheese;
  • animal fats (pork, beef, or cooking);
  • a fish;
  • jellies;
  • sorrel and spinach, cauliflower, rhubarb and figs;
  • rich broths, including mushroom;
  • mushrooms;
  • legumes;
  • alcoholic beverages (especially beer and red wine);
  • tea and coffee (sometimes you can not strong), cocoa and chocolate,
    cranberry juice.

When phosphate stones from the diet are temporarily excluded:

  • foods rich in calcium: dairy products, eggs,
    cocoa;
  • salty and spicy foods (salt limit up to 8 g per
    day);
  • garden greens (lettuce, green onions, dill, parsley, leaves
    celery and cilantro);
  • potatoes;
  • орехи, cocoa;
  • sweet pastry (biscuit, cakes, pies);
  • fruit juices;
  • yeast.

Before using any folk remedies, you need a mandatory
consultation with your primary care physician. Because in the presence of large
stones, possible serious consequences.

AT основном, применяются различные травяные сборы, вид которых
is selected depending on the chemical composition, size and
localization of stones. AT состав лекарственных сборов могут входить
The following medicinal plants:

  • corn silk;
  • burdock root;
  • dog rose;
  • tricolor violet;
  • dandelion roots;
  • grape leaves;
  • currant leaves, etc.

Prevention

Preventive methods of urolithiasis consist of
following recommendations:

  • sufficient physical activity;
  • weight loss to optimal performance;
  • restriction of the use of alcoholic beverages;
  • prevention of stressful situations;
  • expansion of the drinking regimen to 2.5–3 l during the day;
  • restriction of the use of animal proteins, their
    substitution of plant.

If you have urolithiasis, be sure to
начинайте лечение только после согласия врача. Self-medication
can lead to serious complications for the whole body. Be
are healthy!

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