How kidney stones manifest. Reasons for the formation of kidney stones

According to medical indicators in the field of urology, one of the most common urological diseases is urolithiasis - urolithiasis.

One of the forms of this ailment is the development of seals (calculi) in the urinary system - in the kidneys. This pathology is called nephrolithiasis. The formation and growth of calculi can be caused by various factors, ranging from a congenital predisposition to alcohol abuse and inactivity.

About such a phenomenon as kidney stones, they knew in antiquity. According to the data obtained as a result of excavations, this pathology was found in Egyptian mummies.

In this article, we will reveal what causes stones, and also consider the first manifestations of the disease, methods of determination and what to do if a sad diagnosis is nevertheless made.

What does Kidney Stones mean?

Kidney stones on ultrasound, photo. Dense hyperechoic calcinate is visible in the renal pelvis with an acusic shadow.

The kidneys are a bigeminal paired organ that filters and removes metabolic products from the body. When exposed to external negative conditions, a violation of the activity of the organ may occur, which is why the salts dissolved in the urine crystallize and stick to the walls of the renal cups (pelvis). Over time, these deposits turn into calculi - stone-like formations.

The disease manifests itself quickly and acutely.

• Cutting pain in the abdomen, lower back and internal organs can sometimes lead to unconsciousness.
• In men and women, the symptoms are almost the same, they cannot be confused with another ailment.
• Nausea, gag reflex, high fever, sharp cutting pains in the abdomen are characteristic manifestations in pathology.

Why do kidney stones appear?

There are various assumptions explaining the formation of calculi in the internal organs. None of them can be called the most accurate and true.

Experts identify two stress factors that contribute to stone formation:

Endogenous (internal) factors	Exogenous (external) factors
Hereditary predisposition	Consuming foods high in protein
Increased intestinal absorption of calcium	Prolonged hunger
Dysfunction of bone metabolism	Abuse of coffee and alcoholic beverages
Dysfunction of the urinary system	Indiscriminate use of antibiotics, hormones, diuretics and laxatives
Infectious and inflammatory processes	Hypodynamia
Abnormalities in the function of uric acid metabolism and purine metabolism	Living conditions: climatic impact, location
Disease of the function of the parathyroid glands	Occupational occupation
Disruption of the digestive system
Some cancers
Forced bed rest for a long time (after serious injuries)

In other words, the main catalysts that provoke an imbalance in the functioning of the renal system and the formation of stones are:

• insufficient water consumption (ideally, the recommended amount of necessary fluid should be more than 2 liters per day);
• inactivity, sedentary work, lack of physical activity;
• consumption of coffee and caffeine-containing products in large volumes: such food increases the quantitative content of stone-forming substances (calcium, for example) in the urine;
• infectious diseases of the urinary organs;
• overweight;
• hard water and so on

A variety of types of kidney stones. Description

Before starting therapy for urolithiasis, you need to know about the different types of stones that form. In no case can you independently diagnose and eliminate pathology. The chemical content of stones is determined only by medical examination. A stone is a dense formation of a combination of organic substances and minerals.

In no case can you independently diagnose and eliminate pathology.

The type of kidney stones depends on their chemical composition. Let's take a closer look:

Oxalate stone

A high content of oxalic acid salts in the body with an insufficient intake of calcium can induce the development of hard black-gray seals. If these formations are not detected in a timely manner, then the pathology takes the form of a hard stone with a prickly structure. It is an oxalate stone that can be detected using X-rays. Removing it from the organ is possible only by surgery.

Urate stone

Prolonged dehydration of the body leads to the fact that the volume of urine decreases and its acidity decreases. This phenomenon is observed in residents of countries with particularly hot climates, as well as in patients who have undergone chemotherapy or with certain types of cancer. If you do not burden the body with copious drinking of water, this can contribute to the formation of urate stones. Analysis of urine and blood at an early stage of the disease will help prevent further development of stones.

Struvite stones

Struvite stones are considered one of the most dangerous types of stones due to their rapid growth in size, which can lead to more difficult calculus difficult to remove - the coral prickly subspecies. Struvite stones get their start in the case of an infectious process in the ureters. The increased content of the enzyme urease in the urine leads to its splitting and crystallization of salts, which outwardly resemble "coffin lids" (crystals can be detected by examining urine). To eliminate the formed deposits, an operative method of ESWL is used - lithotripsy. To avoid relapse of the disease, the patient should be monitored even after surgery.

Cystine stone

People who have kidney disease, or have had cases in the family, are predisposed to nephrolithiasis. A gene defect can result in the amino acid (cystine) being unable to dissolve in the urine, forming crystalline formations. As these forms grow and combine, the growth and development of the cystine stone begins. The texture of the yellow-white stone is soft, smooth, rounded. It is difficult to detect by x-ray. Therefore, CT of the organ and intravenous urography are more suitable here. Crystals of cystine molecules can be detected through urine analysis. Unfortunately, even the complete elimination of dense deposits will not give relief from subsequent renal colic.

Examples of the norm (on the radiograph on the left) and pathology (on the right) with excretory urography.

Number 1 on the left marks the contrasted cups, number 2 - renal pelvis, 3 - ureters. On the right, blue arrows mark sharply widened cups. Pay also attention to the absence of contrasting of the renal pelvis and ureter - all these are signs of urolithiasis. In this case, the situation is acute - to describe the dilated cups, the term "calicoectasia" should be used (from the Latin "calyx" - renal cup and "-ectasia" - expansion). The term "hydronephrosis" is used in chronic, long-term conditions associated with increased pressure in the urinary tract; in contrast to calicoectasia, with hydronephrosis, atrophic changes in the renal parenchyma are revealed.

Examples of conditions that can reduce the validity of research. Excretory urograms.

On the left, a significant expansion of the renal cavity system is revealed. The bladder filled with contrasted urine is clearly visible. Note the gas-swollen bowel loops that mask the right kidney. On the right, arrows indicate multiple calcifications in the small pelvis, which can mimic stones in the ureter. Usually, these are calcifications in the uterus or in the appendages (in women) or in the prostate gland (in men).

Kidney stones that rarely occur:

The combination of phosphorus salts in alkaline urine leads to the formation of light gray soft phosphate stones.

Urine salt crystals, bacteria and fibrin protein in organ dysfunction can lead to the development of a protein stone.

Rarely, but cholesterol and carbonate stones can be found in the kidneys.

Classification of kidney stones by number and shape

Depending on how many "stones" are found in the kidneys, doctors divide the phenomenon into single formations, multiple, as well as two-calculus and three-calculus formations.
The size and weight of stones vary from 0.1 to 15 cm or more, and from less than a gram to 2.5 kg and more, respectively. Often a growing stone takes the form of a cup-pelvis system (such as an impression), with thickened thick ends. They are called coral. Stones can form in one or both kidneys.
The variety of forms of calculi is very impressive: from shapeless to perfectly round.

Symptoms of urinary tract diseases

A person may not suspect for a long time that there is a foreign formation in the organs. The first symptoms of pathology, as a rule, appear only when the formed stone changes its location. Rather, when it begins to move along the urinary tract. The severity and palpability of pain depends on the shape and size of the stone formation. Small stones (sand) do not always cause discomfort.

The first symptoms of pathology, as a rule, appear only when the formed stone begins to move along the urinary tract.

Here are the most basic signs of a kidney disorder:

• Different degrees of pain sensation, depending on the localization of the stone in the organs
• The presence of blood, pus, and other impurities in the urine
• Violation of the urination process, up to anuria (blockage of the urinary canals with kidney stones)

Dependence of symptoms on the size and position of stones

Stones can be detected by chance, but more often they are found in the case when there are already complaints - during ultrasound or X-ray examinations. The severity of symptoms largely depends on the location of the stone in the urinary tract, on its shape and size, and the presence of sharp edges. So, they can be localized:

1.In the renal calyx (s).

Moreover, even if the size of the formation is large, there may be no symptoms at all. A long-existing stone impedes the outflow of urine from the calyx, can provoke atrophy of the kidney parenchyma, its cystic degeneration.

Computed tomography in identifying kidney stones is a very valuable research method. The blue arrow in the images marks the large calcinate located in the lower group of the cups of the left kidney and (partially) in the pelvis. It can be seen that both the calyx and the pelvis are significantly enlarged, in the lower parts of the kidney tissue is thinned, atrophic, which indicates the duration of the disease.

Same patient, magnified CT and 3D reconstructions. The stone is marked with an arrow.

CT of the kidneys with contrast, arterial-parenchymal phase.

Revealed a small (no more than 4-5 mm in diameter) dense calcinate in the lower calyx on the left. Such stones are more dangerous than large stones, since they can (when washed out and pass into the ureter) cause obstruction (blockage) of the urinary tract and provoke renal colic.

2.In the renal pelvis.

Large accumulations of calcium salts are usually localized here, in their shape repeating the internal contours of the pelvis - the so-called coral stones. Coral kidney stones - what to do? First of all, you need to carefully analyze the results of CT and contact the urologist to decide on the operation. The operation is necessary in case of risk of complications, because if the lumen of the pelvis overlaps, signs of increased pressure in the urinary tract may appear, and hydronephrosis may develop later (persistent expansion of the calyx and pelvis, often in conjunction with atrophy of its parenchyma). We will consider the complications in detail below.

Coral kidney stones, photo.

Computed tomography (CT). The formation is large, but clearly does not impede the outflow of urine - there are no signs of hydronephrosis, thinning of the parenchyma.

3.In the ureter.

When displaced downward (from the renal pelvis into the ureter), painful sensations arise, the severity of which depends on the size of the stone and its shape, the presence of sharp edges. How to identify a stone in the ureter? Ultrasound can be used as the primary method, but CT is more accurate.

How to see a stone in the ureter.

On CT scan of the small pelvis with contrast in the upper row on the left, an arrow marks a small calculus at the orifice of the ureter (where it flows into the bladder), which provokes expansion of the pelvis (upper left) and ureter (in the images in the lower row). In this case, the condition is acute, the patient has an attack of renal colic, therefore, we are talking about ureteropyelectasis (expansion of the ureter and pelvis), and not about hydronephrosis.

4.In the bladder.

Such stones usually have the shape of an "egg" or "ball", measuring 10-20 mm in diameter - they are freely located in the cavity of the bladder (since they are formed in it), usually do not cause any symptoms. If there are many of them and they occupy a significant part of the volume of the bladder, urination may be impaired.

An interesting diagnostic observation.

A large stone in the bladder cavity revealed by X-ray examination of the hip joints (as an accident). The images in the upper row show an X-ray of the pelvis and an axial slice (CT of the small pelvis), a dense shadow in the form of an “egg” with dimensions of 8x6 cm is visible. The image below shows the same stone after surgery. Its layered structure is clearly visible.

5.In the urethra.

Usually, calculi formed in the upper parts of the urinary system pass through the urethra, while pain symptoms are expressed, and if the wall of the urethra is damaged, urine becomes pink from the presence of blood - hematuria.

Medical diagnosis of kidney stones

For competent and complete treatment of urolithiasis, it is necessary to correctly diagnose. Prior to laboratory tests, all information about the possible causes of the pathology is collected from the patient's words. Based on the examination, the tactics of further examination and treatment are determined.

For competent and complete treatment of urolithiasis, it is necessary to correctly diagnose.

In medicine, various methods of detecting a kidney stone are used, depending on the duration of the onset of relapse and the severity of the disease:

• Do an ultrasound of the kidneys
• Bladder ultrasound
• Urography is performed
• Take urine and blood tests
• Thanks to nephroscintigraphy - determine the degree of impaired renal function
• Multispiral CT allows you to determine the type and size of the formation

An example of the detection of renal calcifications by computed tomography (small stones in the renal pelvis are circled). A stone at the orifice of the ureter on the left is also clearly visible (it is marked with a green arrow). A dilated left ureter is visible (ureteroectasia).

The blue arrow marks a large formation in the lower calyx of the left kidney, described by CT as "a concrement of an ovoid shape, with smooth edges, of a homogeneous structure."

Diagnosis of complications of urolithiasis

The presence of calculi does not go unnoticed. If they exist for a long time, there is a high risk of developing various complications. For example, in all cases, even after the passage of the stone through the ureter, an expansion of its lumen (ureteroectasia) is observed for some time, an expansion of the lumen of the pelvis (pyelectasis) and calyces (calycectasia) can also be detected. This condition is temporary and disappears after the cause of the violation of the outflow of urine is eliminated.

If calculi exist for a long time, there is a high risk of developing various complications.

If the obstruction to the outflow of urine exists for a long time, the expansion of the urinary tract becomes persistent and is combined with a decrease in the volume of the renal parenchyma. This condition is called "hydronephrosis". Hydronephrosis can be of varying degrees of severity - from minimal expansion of the calyx-pelvic system to terminal (in which the kidney becomes like a thin-walled "bag" filled with fluid). Of course, such a kidney does not fulfill its function in any way.

CT of the kidneys. Pronounced right-sided hydronephrosis and hydroureter.

Cystic degeneration of the right pyelocaliceal system, normal kidney tissue is virtually invisible due to thinning, atrophy. On the right, the arrow indicates the cause of hydronephrosis - a stone in the lower third of the ureter, obstructing (blocking) its lumen.

Against the background of stagnant phenomena in the calyx-pelvic system (especially with concomitant diabetes mellitus), there is a high risk of infectious complications - pyelonephritis (and even pyonephrosis - a condition in which the kidney becomes a bag filled with pus), cystitis, urethritis.

Right-sided hydronephrosis due to ICD, complicated by pyelonephritis.

Expanded cups are marked by arrows in the images in the upper and lower rows. Pay attention also to the sharp obstruction of the outflow of urine from the right into the excretory (10 minutes after the introduction of ultravist into the vein) phase in the image below on the right. Perirenal tissue is cloudy, has a heterogeneous structure (due to edema, infiltration). In the analysis of urine - leukocytes.

Why are kidney stones dangerous?

The table lists the possible consequences of nephrolithiasis.

The best treatment is good habits

The most optimal and timely action for the prevention of kidney stone formation is your good habits:

• Drink clean water daily at least 2.5 liters per day
• Regular walks in the fresh air
• Compliance with the rules of personal hygiene
• Eliminate "heavy" foods from the diet, fried

Well, if calculi have already been found in the kidneys, then it is necessary to strengthen all these actions. Additionally, observe the following rules:

• drink only filtered, soft water;
• follow a strict diet, developed personally for your case;
• in cold weather, insulate the lumbar region, prevent hypothermia;
• avoid infectious diseases that are sexually transmitted;
• limit the use of coffee, tea, caffeine-containing products;
• increase the use of diuretic drinks: cranberry juice, green tea, drinks from decoctions of anti-inflammatory herbs;
• if you are overweight, try to reduce it.

What not to do if kidney stones

It is categorically impossible to self-medicate. It was described above that even after the removal of foreign bodies from the kidneys, the consequences of pathology may occur, which will only complicate the healing process of the affected organ.

Diagnosis and treatment of urolithiasis should be carried out only in a clinical setting.

During the period of exacerbation and treatment of nephrolithiasis, it is recommended to limit, and it is better to completely exclude the following foods:

• greens and vegetables rich in oxalic acid and vitamin C
• broths from meat, fish, mushrooms;
• chocolate, peanut butter, sweet and flour products, fruit preserves;
• strong tea, coffee;
• carbonated drinks;
• milk drinks;
• hot spices and seasonings;
• sour fruits, berries;
• legumes.

What to do if you have been diagnosed with kidney stones, but there are doubts

No one can be insured against medical error. Therefore, you can always get a "Second Opinion" of independent experts based on the analysis results.

Our service will help you find an individual solution in case of doubt about the diagnosis. You can always count on independent advice from leading experts in the field of X-ray, CT and MRI, revision of the examination to confirm or deny the disease.

You can always get a "Second Opinion" of independent experts based on the analysis results.

The Second Opinion service is a service where you can get a remote consultation from the best radiologists. Top-class specialists carry out a detailed transcript of CT, MRI, X-ray, mammography images.

This service will help you avoid possible mistakes and choose the right course of recovery in your personal case.

Medium stones are more likely to form in the kidneys. When they are fixed at the site of formation, there may not be any symptoms. However, when the stone moves along the ureter in the places of greatest narrowing, the stone clogs the ureter - symptoms of renal colic appear.

Renal colic symptoms

Common symptoms:

• Paroxysmal pain - periodically worsening
• Increase in body temperature is possible

Laboratory signs:
General urine analysis :

• Salts in urine
• Red blood cells in urine
• Cloudy urine

Symptoms of stones of different localization

Symptoms of stones in the renal calyx

The renal calyx is the initial section of the urinary tract into which the collecting tubules of the kidney nephrons open. In each kidney, filtered urine accumulates in the renal pelvis, passing through the system of cups (there can be from 6 to 12 in each kidney).

Most often, calyx stones are small and are excreted in the urine. With profuse urination (with copious drinking, drinking alcohol, taking diuretics). Exacerbation of pain is possible due to the active advancement of stones.
The nature of the pain:

• Paroxysmal pain
• Localized pain in the lumbar region in the lower abdomen or in the groin area.
• The pains are aggravated by shaking, active movements.

Symptoms of stones in the renal pelvis

The renal pelvis is the most capacious part of the urinary calving of the kidney - all the urine formed in the kidney flows into it and accumulates. Each kidney has 1 pelvis into which the renal cups open and from which the ureters originate.
More often, stones of medium size or large (coral-shaped) are formed in the pelvis.

Medium stones most often cause a serious condition - blockage of the ureter and an attack of renal colic.
Renal colic symptoms:
Common symptoms:

• Paroxysmal pain - periodically worsening,
• The pain occurs suddenly, more often when moving, shaking, drinking copious amounts of fluids or alcohol. The change in position does not reduce the pain.
• Increase in body temperature is possible
• Pain can be given to the lumbar region, to the lower abdomen, to the groin (depending on the level of ureteral obstruction).

Coral stones are fixed in the renal pelvis, do not cause renal colic, but can lead to frequent infectious diseases of the kidneys (pyelonephritis, pyelitis), in some cases cause atrophy of the entire kidney.

Ureteral stones

The intensity of pain in urolithiasis depends on the localization of the stones, on their size, the smoothness of the surface.

Localization of the stone in the upper third of the ureter

• Lumbar pain
• The pain is acute, periodically subsides (but not completely), with periods of intensification
• Change in body position does not affect the intensity of pain
• Pain can radiate to the lateral parts of the abdomen

Localization of the stone in the middle third of the ureter manifested by the following symptoms:

• The pain is localized in the lateral projection of the abdomen - along the lower costal edge
• Gives to the iliac and groin areas
• The change in body position does not affect the intensity of the pain.

Localization of a stone in the lower third of the ureter manifested by the following symptoms:

• Localization of pain - lower abdomen, groin area
• Pain radiates to the scrotum / outer labia
• Feeling of full bladder
• Frequent urge to urinate
• The urination itself is painful, does not lead to a sensation of emptying the bladder

Bladder stones

The external manifestations of bladder stones are:

• Recurrent pain in the lower abdomen
• Pain can be given to the perineum, external genitals
• Pain worsens or occurs with movement
• When urinating, the stream of urine may suddenly break off; when the position of the body changes, the urine flow may resume.

Reasons for the formation of stones

External factors contributing to the development of stones:

• Climate (dry, leading to frequent dehydration)
• Soil structure - affects the electrolyte composition of food
• Chemical composition of water - excessive presence of salts in water can increase their concentration in urine. The acidity of the water is also of great importance for stone formation in the urinary organs.
• Fluid regimen and intake - Not drinking enough fluids increases the risk of stone formation.
• Daily routine - a sedentary lifestyle contributes to the formation of stones
• The composition of the daily consumed food - excessive consumption of meat products, foods with a high content of purine bases (peas, sorrel, spinach, etc.).

Internal factors in the development of urolithiasis:

• Urinary tract infections: cystitis, urethritis, prostatitis, pyelonephritis
• Infectious diseases of other organs (tonsillitis, furunculosis, osteomyelitis)
• Diseases of the digestive tract: colitis, pancreatitis, cholelithiasis, hepatitis
• Abnormalities in the development of the kidneys, ureters, bladder.

Diagnosis of urolithiasis

The diagnosis of urolithiasis is made on the basis of the following data:

Symptoms of the disease

1. recurrent acute pains (like colic) in the lumbar region, lower abdomen or groin)
2. incomplete emptying of the bladder
3. burning sensation in the urethra when urinating

Treatment data - in the past, the diagnosis of urolithiasis and the effectiveness of the treatment carried out help the doctor in setting the correct diagnosis and adequate correction of treatment.

Examination and physical examination data of the patient

1. palpation of the abdomen - allows you to exclude many acute inflammatory diseases of the abdominal cavity (pancreatitis, adnexitis, appendicitis, cholecystitis). These diseases in external signs and symptoms can be similar to an attack of renal colic.
2. tapping the abdomen and lumbar region - allows you to exclude or identify signs of diseases such as: sciatica, lumbago, pyelonephritis.
3. external examination of the patient - a forced posture of the patient (in which he feels a decrease in pain), the presence of edema, skin color can indicate many diseases of the urinary system.

Ultrasound examination data- often this examination alone makes it possible to accurately diagnose urolithiasis and identify the shape, size and localization of stones.

CT diagnostic data This examination allows you to accurately diagnose urolithiasis and identify the shape, size and location of stones.

Radiopaque diagnostic data - this method is used for a more detailed study of the flow of urine through the urinary tract, allows you to identify at what level there is a blockage of the urinary ducts.

Data from the study of the general analysis of urine- the presence of urolithiasis may be evidenced by the following data:

1. Increased urine density
2. The presence of unchanged red blood cells
3. The presence of a high concentration of salts
4. Detection of sand in urine

Treatment of kidney stones with medications

Direction of treatment	Why is it appointed?	How to use?**
Antispasmodics: No-shpa Papaverine Diprofen Galidor	Antispasmodic drugs relieve spasm of the ureter, provide relaxation of its wall. Due to this, the pain syndrome decreases, the passage of stones is facilitated.	No-shpa: 0.04 - 0.08 g. Available in 0.04 g tablets. Papaverine: 0.04 - 0.08 g 3 - 5 times a day. Available in tablets of 0.01 and 0.04 g. Diprofen: 0.025 - 0.05 g 2 - 3 times a day. Available in tablets of 0.05 g. Galidor: 0.1 - 0.2 g 1 - 2 times a day. Available in tablets and dragees, 0.1 g each. Also, these drugs are used for renal colic injections, strictly according to the doctor's prescription.
Pain medications: Baralgin Took Tempalgin Tetralgin Pentalgin	Pain relievers are mainly used during an attack of renal colic to relieve pain.	A single dose of analgin for adults - 0.5 - 1 g. Can be used in tablets or solution for injection. The maximum daily dose is 2 g.
Antibacterial drugs	Antibiotics are prescribed when an infection is associated with urolithiasis.	The choice of antibacterial drugs can only be carried out strictly by a doctor after an examination.

** Prescription of medicines, determination of dosage and time of administration is carried out only by the attending physician.

Dissolving stones with medicines

Drug name		Why is it appointed?	How to use?
Treatment of urate stones
Allopurinol and synonyms: Allozyme Hello Allopron Allupol Milurite Zilorik Remid Purinol Sanfipurol	Allopurinol inhibits the activity of xanthine oxidase, an enzyme that converts hypoxanthine*** v xanthine****, and xanthine - in uric acid*****. Reduces the deposition of urates (uric acid salt) in organs and tissues, including the kidneys. It is prescribed for the treatment of urolithiasis with the formation of urate stones and other diseases accompanied by an increase in the level of uric acid in the blood (gout, hyperuricemia, leukemia, myeloid leukemia, lymphosarcoma, psoriasis, etc.)			Allopurinol is available in 0.1 and 0.3 g tablets. Dosages: for adults with a slight increase in the content of uric acid in the blood: first 0.1 g daily, then 0.1 - 0.3 g each; adults with a significant increase in the content of uric acid in the blood: in the first 2 weeks, 0.3 - 0.4 g daily (3 - 4 doses per day, 0.1 g each), then - 0.2 - 0.3 g daily ; children: at the rate of 0.01 - 0.02 g of the drug for each kilogram of body weight. Contraindications: significant impairment of liver and / or kidney function; pregnancy. While taking the drug, periodic monitoring of the uric acid content in the blood is carried out. If allopurinol is canceled, then on days 3-4, the level of uric acid in the blood rises to the initial value. Therefore, the drug is prescribed in courses for a long time. The tablets are taken before meals.
Etamide	The drug promotes more intensive excretion of urate in the urine. Reduces the content of uric acid salts in the urine.			Etamide is available in 0.35 g tablets. Dosage: adults - 0.35 g 4 times a day (course duration - 10 - 12 days, then a break of 5 - 7 days, and another course lasting a week). Contraindications: severe liver and kidney disease. The tablets are taken before meals.
Ugly The combined preparation is a mixture of the following medicinal substances (the content is given per 100 g of the medicinal product): piperazine phosphate - 2.5 g; hexamethylenetetramine - 8 g; sodium benzoate - 2.5 g; lithium benzoate - 2 g; sodium phosphate - 10 g; sodium bicarbonate - 37.5 g; tartaric acid - 35.6 g; glucose - 1.9 g	Urodan alkalizes urine. The main active ingredient is piperazine phosphate. It combines with uric acid to form soluble salts.			The drug is produced in granules intended for dissolution in water. Adults take Urodan before meals by dissolving 1 teaspoon of granules in ½ glass of water. Frequency rate of admission - 3 - 4 times a day. The course of treatment is 30 - 40 days.
Uralit-U Combined preparation, which includes: sodium citrate potassium citrate citric acid	Uralit-U can be used to dissolve existing urate stones and prevent the formation of new ones. The drug is effective for cystine stones (see below).			The drug is produced in the form of granules, which are packaged in cans of 280 g. A set of indicator papers is attached to the can to control the acidity of urine. The dose is selected by the attending physician, depending on the data shown by the indicator papers. To dissolve stones, urine acidity should have a certain value. Contraindications: infections of the genitourinary system and the detection of bacteria in the urine, severe circulatory disorders.
Blemaren. A complex preparation, which includes the following components: 39.9 parts citric acid 32.25 parts of sodium bicarbonate 27.85 parts sodium citrate	The drug has the ability to dissolve urates and other types of urinary stones.			Blemaren is available in the form of granules, packaged in 200 grams. Includes a measuring spoon and urine acidity test strips.
Solimok. A complex preparation, which includes the following components: 46.3% potassium citrate 39% sodium citrate 14.5% citric acid 0.1925% glucose 0.075% dye	The drug is able to dissolve urinary stones, mainly urates.			Solimok is produced in the form of granules, packaged in cans of 150 g. Reception scheme: 2.5 g in the morning after eating 2.5 g for lunch after meals 5 g in the evening after meals
Phosphate stone treatment
Dry extract of madder dye. A medicinal product based on herbal raw materials, which contains: madder dye extract madder georgian extract	The goals of prescribing the medicinal product: loosening of urinary stones, which are formed by magnesium and calcium phosphates; antispasmodic action: due to the removal of spasms of the ureters and renal pelvis, madder extract facilitates the passage of small stones; diuretic action: promotes the removal of stones and salts from the kidneys.			Madder dye extract is available in the form of 0.25 g tablets. Take 2-3 tablets 3 times a day, after dissolving them in a glass of water. The course of treatment usually lasts from 20 to 30 days and can be repeated after 1 to 1.5 months.
Marelin Composition of the preparation: dry extract of madder dye - 0.0325 g; dry extract of field horsetail - 0.015 g; dry goldenrod extract - 0.025 g; monosubstituted magnesium phosphate - 0.01 g; korglikon - 0.000125 g; kellin - 0.00025 g; sodium salicylamide - 0.035 g.	Marelin Effects: helps to soften kidney stones, which are composed of calcium phosphates and oxalates; relieves spasm of the ureters and renal pelvis, facilitating the passage of small stones; relieves inflammation in the genitourinary system.			The drug is available in tablet form. Application methods: to destroy existing stones: 2 - 4 tablets 3 times a day, the course of treatment is 20 - 30 days, after which they take a break for 1 - 1.5 months, and then repeat the course of treatment again; to prevent recurrence after removal of kidney stones: 2 tablets 3 times a day for 2 - 3 months, if necessary, repeat the course of therapy after 4 - 6 months. Taking Marelin can provoke an exacerbation of gastric ulcer and inflammatory bowel diseases. Therefore, for patients with pathologies of the digestive system, the drug is prescribed with caution, taking it strictly after eating.
Treatment of oxalate stones
Marelin(see above)
Spilled Herbal preparation, dietary supplement (included in the radar).	Helps dissolve oxalate stones. Improves metabolic processes in the body and the composition of urine. Contains organic acids, tannins, potassium.			The drug is available in the form of pills and capsules, the composition of which is somewhat different. Dosages and method of taking capsules for adults: from 1 to 2 capsules 2 to 3 times a day, the course of treatment is 4 to 6 weeks. Dosage and method of taking pills for adults:
Collection of medicinal plants for the preparation of decoctions and ingestion: · collection number 7; · collection number 8; · collection number 9; · collection number 10.	They are medicines that are officially used in urology. The effects of medicinal plants included in the composition of the fees: · diuretic; · litholytic(help dissolve oxalate stones); · antispasmodic(eliminate spasms of the urinary tract and promote the discharge of small stones).			The dosage is determined by the attending physician. The charges are brewed in boiling water, take 1 - 2 tablespoons 3 times a day.
Treatment of cystine stones
Penicillamine	A drug that is capable of forming a compound with cystine called penicillamine-cysteine ​​disulfide... It dissolves in the urine much more easily, and this helps to reduce the formation of cystine stones.			Penicillamine available in capsules and soluble-coated tablets. Dosages of the drug: Adults - 1-4 g per day (usually prescribed 2 g per day); · Children - at the rate of 300 mg per kilogram of body weight per day.
Thiopronin	Able to form soluble compounds with cystine. It is used with a high content of cystine in the urine (excretion of more than 500 mg of cystine per day), in cases where penicillamine is ineffective.			Dosages of the drug: Children under 9 years of age: first, 15 mg of Thiopronin is prescribed for each kilogram of body weight, the indicated dosage is divided into three doses, then it is adjusted depending on the cystine content in the urine; Adults: first, a dosage of 800 mg is prescribed daily, then it is adjusted depending on the cystine content in the urine, but not more than 1 gram per day.
Sodium bicarbonate(soda) Potassium citrate	Drugs that alkalize the urine, helping to dissolve cystine stones (the solubility of cystine depends on the pH of the urine: the lower the acidity, the better it dissolves).			Sodium bicarbonate dosage: 200 mg per kilogram of body weight daily. Potassium citrate dosage: 60 - 80 HONEY per day (prescribed by a doctor).
Uralite (see above)
Treatment of struvite stones
With struvite stones, drug therapy is ineffective. The stone is destroyed using special methods or surgically removed.

Treatment of urinary stones with folk remedies

Type of stones	Type of treatment (mineral water, infusions, decoctions, diet)	Purpose of treatment	How to cook (decoction, tincture, composition and principle of the diet)
Struvites	Traditional methods of treatment for struvite stones, like all conservative methods, are ineffective.
Phosphates	Plant infusions: rose hip knotweed grape quarry thigh barberry		Rosehip infusion: 3 tablespoons of dry berries in a glass of boiling water, leave for 6 hours. Infusion of knotweed: Take 20 g of a dry plant and brew in 200 ml of boiling water. Infusion of grape leaves: 1 tbsp. Brew a spoonful of dry leaves in 1 tbsp. boiling water, leave for 15 - 20 minutes, drain. Infusion of quarry thigh: 1 tablespoon of rhizomes is brewed in 1 cup of boiling water. Can be mixed with rosehip infusion, honey. Usually, the infusions of these plants are taken 2 - 3 times a day.
	Herbal collection: 2 parts corn silk 2 parts birch leaves 1 part juniper berries 1 part snake knotweed root 1 part burdock root 1 piece of steel root	They have a diuretic, antispasmodic, some litholytic effect.	Brew 1 tablespoon of the mixture in 1 cup of boiling water. Simmer for another 15 minutes. Take an infusion of 1 glass 3 times a day.
	Herbal collection from the following plants: violet tricolor larkspur St. John's wort bird highlander dandelion roots	They have a diuretic, antispasmodic, some litholytic effect.	Take the indicated dry plants in equal proportions. Pour boiling water over with one liter. Insist for some time. Take one glass of infusion three times a day.
Urata	Oats	It has a diuretic and antispasmodic effect.	Take the husked oat grains and rinse under tap water. Put in a thermos, pour boiling water over. Insist for 10 to 12 hours. Then rub through a fine sieve. You will get a porridge that you can eat with urolithiasis daily for breakfast. Add sugar, honey to taste.
	Herbal collection from plants: currant leaves - 2 parts; strawberry leaves - 2 parts; Highlander's herb - 1 part.	The listed herbs have a diuretic, antispasmodic, some litholytic effect.	Mix the herbs in the indicated proportions, take a tablespoon of the resulting mixture. Brew boiling water in a glass, drain. Take an infusion of 2 tablespoons before meals 3-4 times daily.
Oxalates	Watermelon diet	Watermelons have a strong diuretic effect and help remove sand from the kidneys.	Within 1 - 2 weeks, you need to eat watermelons with a little rye bread. A particularly pronounced effect is observed from 17.00 to 21.00, when the human urinary system works most actively.
	Grapes (leaves, young mustache, plant branches)		Take 1 teaspoon of the indicated plant parts harvested in spring. Pour a glass of boiling water over. Heat in a water bath for 2 to 3 minutes. Then insist for some time. Take ¼ glass 4 times a day.
Cystine	With cystine stones, medicinal plants are practically ineffective, since the development of the disease is associated with a hereditary violation of the process of excretion of cystine from the body.

Attention! The use of traditional methods of treating urolithiasis is possible only after consulting your doctor.

Physiotherapy for urolithiasis

Treatment type	Purpose of appointment	How is it done?
Dynamic amplipulse therapy	The essence of the procedure: the effect on the body of sinusoidal modular currents. : pronounced analgesic effect. Appointment	The procedure can be performed once to eliminate pain during an attack of renal colic. Special electrodes are applied to the area of ​​the kidney and ureter. The exposure is generally about 10 minutes.
	The essence of the procedure: exposure to a magnetic field on organs and tissues through the skin using special equipment. Effect on urolithiasis: Removal of pain syndrome, swelling, improvement of blood circulation and regenerative processes in tissues. Appointment: during an attack of renal colic, with severe pain syndrome.	The procedure takes 10-15 minutes. The total number of procedures is 5 - 10. Use two inductor cylindrical shape: one of them is leaned against the skin of the abdomen in the lower part of the ureter, and the other is carried out from top to bottom along the movement of the stone.
Inductothermy	The essence of the procedure: exposure of organs and tissues to a high frequency magnetic field. As a result, deep tissue heating and other effects occur. Effect on urolithiasis: Analgesic, antispasmodic effect (elimination of ureteral spasms). Appointment: during an attack of renal colic, with severe pain syndrome.	A special inductor is leaned against the skin, which has a cylindrical shape with a diameter of 12 cm. The procedure is usually performed 30 minutes after aplipulse therapy. Carrying out time - 30 minutes. It is performed once to relieve an attack of renal colic.
Electrical stimulation of the ureter with impulse currents	The essence of the procedure: action on organs and tissues with a pulsed current using special electrodes. Effect on urolithiasis: removal of edema, spasm, inflammation. Improvement of blood flow and outflow of venous blood. Appointment	The procedure is carried out for 10 - 15 minutes daily, the total duration of the hen is 6 - 7 procedures. The impact is carried out by two electrodes: one is placed on the lumbar region, the second - on the abdomen in the projection of the ureter.
Electrical stimulation of the ureters with sinusoidal simulated currents	The essence of the procedure: effect on tissues through the skin with sinusoidal simulated currents with certain characteristics through the skin. Effect on urolithiasis: pain reliever. Improving nutrition, blood supply to tissues. Removal of edema and spasm of the ureters. Appointment: for the treatment of urolithiasis outside the period of exacerbation, when urinary colic is absent.	The time of the procedure is 12 - 15 minutes. After 4 - 5 procedures, a small stone should come off. If this does not happen, then the current strength is increased and several more procedures are carried out.
High Intensity Pulsed Magnetic Therapy	See above.	The technique is the same as in the relief of an attack of renal colic. The duration of the procedure is 10-15 minutes. The general course of treatment is 5-10 procedures.

Treatment of urolithiasis in the sanatorium

Type of kidney stones	Sanatoriums and resorts where you can undergo treatment	Mineral waters used and names of the most popular springs.
Oxalates	Kislovodsk Pyatigorsk Essentuki Zheleznovodsk Berezovsk (Ukraine) Sairme (Georgia) Truskavets (Ukraine)	Dolomite narzan Lermontovsky number 2 Krasnoarmeyskiy number 1, number 7 Narzan Essentuki number 20 Essentuki No. 4 (used only for rehabilitation purposes after stone removal) Smirnovsky number 1, Slavyanovsky, Lermontovsky Berezovskaya Sairme No. 1, No. 4
Urata	Kislovodsk Essentuki Berezovsk-Ukraine Zheleznovodsk Sairme-Georgia Borjomi-Georgia Truskavets-Ukraine	Dolomite narzan Essentuki number 20 Essentuki No. 17 Essentuki No. 4 (only with uraturia, without stone); Berezovskaya them. Semashko Lermontovsky Smirnovsky No. 1, Slavyanovsky; Sairme Borjomi Naftusya, Truskavetskaya (bottle)
Cystine	Kislovodsk Essentuki Berezovsk-Ukraine Zheleznovodsk Sairme-Georgia Borjomi-Georgia Truskavets-Ukraine	Dolomite narzan Essentuki No. 4 (only after removing the stone, when the content of cystine in the blood is increased), No. 17, No. 20 Berezovskaya them. Semashko Slavyanovskiy Lermontovsky Smirnovsky number 1 Sairme Borjomi Truskavetskaya Naftusya, (in bottles)
Phosphates	Berezovsk (Ukraine) Kislovodsk Essentuki Zheleznovodsk Truskavets (Ukraine)	Berezovskaya Dolomite narzan Essentuki number 20 Drilling station No. 54 Vladimirsky Smirnovsky number 1 Naftusya Truskavets (bottled) - when using this mineral water, you need to constantly monitor the pH and composition of urine sediment

Methods for crushing kidney and ureter stones(lithotripsy)

Method	Description	How is it done, indications and contraindications
Remote lithotripsy	One of the safest treatments for urolithiasis. A special apparatus is used that generates waves. They crush the stone, which disintegrates into a large number of small fragments. Subsequently, these small fragments easily pass away with the urine stream.	The procedure is carried out within 40 - 90 minutes. Can be performed with or without anesthesia. Indications for extracorporeal lithotripsy: the presence of a small kidney or ureter stone (from 0.5 to 2 cm); the stone is well contoured on x-rays. Contraindications: pregnancy; inflammatory process in the kidneys; overlap of the lumen of the ureter and impaired outflow of urine; impaired renal function; serious condition of the patient, when it is simply impossible to put him on the table for manipulation.
Contact lithotripsy	Endoscopic manipulation. Breaking up kidney stones using shock waves that are generated by a device inserted through the urethra, bladder and ureter. Types of contact lithotripsy: Ultrasonic stone crushing... With the help of ultrasound, stones can be crushed into small particles (up to 1 mm), and then removed using special equipment. The technique allows you to destroy only stones of low density. Pneumatic stone crushing... It is carried out with the help of a strong jet of air, equipment that works on the principle of a jackhammer. The fragments are then removed with special endoscopic forceps. This technology does not allow crushing very dense stones. Pneumatic crushing is not possible if the stone is located inside the kidney. Crushing stones with a laser... The most modern, effective technique. The laser beam is capable of destroying even relatively large and dense urinary stones, turning them into dust.	The intervention is performed under general anesthesia. The doctor inserts special endoscopic equipment through the urethra, enters the bladder cavity, and then into the ureter (if necessary, into the renal pelvis). Ultrasound, laser radiation or a jet of air are delivered directly to the stone, so they do not harm the surrounding healthy tissue. The duration of the manipulation depends on the shape, density and number of stones. After 1 - 2 days after lithotripsy, the patient can be discharged home and start his usual business.
Percutaneous (percutaneous) contact lithotripsy	Endoscopic technique, which involves the introduction of equipment for crushing stones through a puncture in the lumbar region. In this case, you can crush large stones, as well as coral stones located in the renal pelvis and calyx.	The intervention is carried out under anesthesia in a hospital. After percutaneous lithotripsy, the patient can be discharged from the hospital after 3 to 4 days.
Litolapoxia	Litolapoxia- endoscopic method of destruction of urinary stones located in the bladder cavity. To do this, the surgeon inserts the urethra with a special instrument - a lithotripter. After the stone is destroyed, it can be removed with suction or flushing the bladder cavity.	The intervention is carried out in a hospital under general anesthesia.

Operations for urolithiasis

Today, open surgical interventions with an incision in the treatment of urolithiasis are less and less resorted to due to the emergence of modern low-traumatic and effective endoscopic techniques.

Indications for surgery for urolithiasis:

• large sizes of stones when they cannot be crushed and removed without surgery;
• significant impairment of renal function, while other methods of treatment in this case are contraindicated;
• position of the stone: if it is inside the kidney, then it is very difficult to crush it and bring it out;
• complication in the form of a purulent process in the kidneys (purulent pyelonephritis).

Types of surgical interventions for urolithiasis:

Pielolithotomy... Removal of urinary calculus from the renal pelvis through an incision. Often, such an intervention is resorted to in the presence of large stones, coral stones.

Nephrolithotomy... Complex surgical intervention, which is carried out with especially large stones that cannot be removed through the renal pelvis. In such situations, an incision is made directly through the kidney tissue.

Ureterolithotomy... An operation that is currently performed very rarely. This is the removal of the ureteral calculus through an incision in the wall of the ureter. In most cases, the removal of such stones can be performed using endoscopic techniques, without incision.

Help with renal colic

If you suspect an attack of renal colic, it is necessary to call the ambulance team as soon as possible. It is undesirable to take any medication before the arrival of the doctor. They can lubricate existing symptoms and make it difficult to diagnose once the doctor is on site.

If the pain bothers the left, then you can apply a hot water bottle to the kidney area, take antispasmodics (No-shpa, Drotaverin, Papaverin).

First aid is provided by the ambulance team on site and in the admission department of the hospital, where the patient is delivered. A combination of drugs is introduced.

The composition of the mixture:

• analgin (or baralgin) - pain reliever;
• papaverine - antispasmodic (eliminates spasm of the ureters);
• dibazol - antispasmodic, lowers blood pressure.

Indications for hospitalization with urolithiasis

• after the medication has been administered, the acute pain does not go away;
• increased body temperature, vomiting;
• lack of urine as a result of the stone blocking the lumen of the ureter;
• an attack of renal colic is bilateral;
• the patient has only one kidney.

Diet for urolithiasis

Type of stones	Diet recommendations	Explanations
Urata	Limiting the consumption of foods containing purines - the molecules that make up nucleic acids. Most of the purines are found in meat products.	Purine-rich foods: animal and fish meat, offal, mushrooms, legumes, meat broths. Dishes from them are recommended to be consumed no more than 1 time per week.
	Limiting the consumption of foods that interfere with the excretion of uric acid in the urine. Alcohol has this ability.	Patients with uric acid stones should not drink beer, red wine.
	The patient's diet should consist mainly of foods that do not contain purines: vegetables and fruits, milk and dairy products, eggs.	Featured Products
		mild cheeses tomatoes potato Bell pepper buckwheat seeds and nuts eggplant fruits and berries	millet barley grits pasta cottage cheese
Oxalates	In terms of chemical structure, oxalates are oxalic acid compounds. Therefore, with oxalate urolithiasis, sorrel and foods rich in vitamin C are limited.	Limit in the diet
		beets spinach salad Coffee and tea parsley celery jellies cocoa and chocolate beans (green)	carrot beef chicken sauerkraut sorrel sour apples lemons, oranges and other citrus fruits currant tomatoes
	Inclusion in the diet of a large number of foods rich in magnesium, calcium, vitamin B6.	Products containing essential substances: whole grains potato nuts	Allowed Products: dairy products (preferably consumed in the morning) cereals watermelons bananas apricots pears peas pumpkin cabbage potatoes
Phosphates and struvites	Limiting foods that are high in calcium and alkaline. Phosphates are calcium salts that form most intensively in an alkaline environment.	Foods to be limited for phosphate urinary calculi: cowberry currant cranberry limit consumption of all vegetables and fruits milk and fermented milk products cheeses and cottage cheese
	Limit foods that increase gastric acid production. The more hydrochloric acid is formed, the more the body loses acidic ions. This leads to additional alkalization of the urine.	Limit intake of the following foods: carbonated drinks hot spices alcohol
	Limiting salt in the diet.	Consuming a lot of salt causes the body to lose large amounts of calcium in the urine.
	Increase the amount of foods in the diet that contain a small amount of calcium, have an acidic reaction. Increase your intake of vitamin A.	Recommended products: butter vegetable oil various soups pasta
	Drinking acidic drinks. They increase the acidity of urine and prevent the formation of phosphates.	Juices and fruit drinks made from sour fruits and berries (apples, citrus fruits, cranberries, etc.) are recommended.
Cystine stones	Foods high in cystine are strictly prohibited.	By-products: liver; spleen; kidneys, etc.
	It is necessary to limit foods in which cystine is found in sufficiently large quantities.	meat and fish: allowed at 200 - 250 mg daily no more than 5 days a week eggs: no more than 1 pc. in a day legumes Wheat flour
	To increase the content in the diet of foods rich in vitamins and biologically active substances.	watermelon oranges grape cowberry Birch juice pear Garnet lemon Strawberry	pear olives dogwood mandarin Rowan nuts carrot apples blueberry currant

How are kidney stones formed?

There are several versions as to how kidney stones are formed and what leads to their appearance. According to the latest data, stone formation is a complex process, which is influenced by many factors:

• Genetic predisposition;
• Bad ecology;
• Power supply features;
• Region of residence - in some areas the water is hard and contains a lot of salts;
• Hormonal imbalance, especially disorders of the parathyroid gland;
• Metabolic disorders, in particular mineral metabolism;
• Anatomical features of the structure of the kidneys and urinary tract (weakness of the ligaments that support the kidney);
• Deficiency of substances that slow down crystallization (citrate, pyrophosphate, nephrocalcin, uropontin);
• Inflammation in the renal pelvis;
• Reception of sulfonamides and tetracyclines, nitrofuran together with ascorbic and other acids.

A combination of several of these factors causes the patient to develop chronic crystalluria- pathology in which crystals of various salts appear in the urine. Stone formation is a complication of this condition. Depending on the pH of the urine and the type of salt, various calculi (accumulations of crystals) begin to form. Usually, the collecting ducts and pelvis become their place of birth.

The process of stone formation begins with the fact that the concentration of salts in the urine increases, and they become insoluble. Salts crystallize around a colloidal "core" - a large organic molecule that forms the basis of a kidney stone. Subsequently, new crystals form and grow on this matrix.

Recent studies have found that almost all stones (97%) contain nanobacteria, so named because of their small size. These atypical gram-negative (not stained by the Gram method) microorganisms in the process of life produce apatite (calcium carbonate). This mineral is deposited on the walls of the kidney cells, promoting crystal growth. Nanobacteria infect the epithelium of the collecting ducts and the zone of the papillae of the kidneys, creating around themselves foci of crystallization of calcium phosphate, and thereby contribute to the growth of the stone.

What stones are formed in the kidneys with urolithiasis?

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

In 30% of women who suffered from urolithiasis before pregnancy, exacerbations occur, especially in the third trimester. This is due to a change in the drinking regimen and a thickening of the mucous membrane of the walls of the ureters. In addition, hormonal and anatomical changes in the body of a pregnant woman contribute to the development of inflammation around the stone, which leads to pyelonephritis.

Causes of the appearance and exacerbation of KSD in pregnant women.

• Salt metabolism disorder. During the period of childbearing, phosphorus-calcium metabolism and reabsorption (reabsorption from primary urine) of uric and oxalic acids are disturbed. Therefore, stones are mainly formed phosphates, urates and oxalates.
• Decreased tone and expansion of the renal calyces and pelvis ... Their volume doubles compared to the pre-pregnancy period. A decrease in tone leads to the fact that the sand is not excreted from the kidney, but is overgrown with new crystals.
• Frequent urinary infections in pregnant women, in which mucus, pus and epithelial cells take part in the formation of the nucleus of the stone. The infection rises from the bladder with vesicoureteral reflux (urinary backflow), penetrates by the lymphogenous route with constipation or hematogenous with inflammatory bacterial diseases.
• Exposure to the hormone progesterone on the receptors of the urinary tract. Under its influence, the processes of formation and excretion of urine slow down. A decrease in the tone of the ureter from the 3rd to the 8th month causes stagnation of urine in the pelvis.
• Pathological mobility of the kidney can twist the ureter and obstruct the flow of urine. It develops due to the fact that the ligaments in pregnant women become more elastic and weakened.
• Uterine pressure. In the second half of pregnancy, the uterus deviates to the right and compresses the ureter, impairing the dynamics of urine. In this regard, a predominantly right-sided lesion occurs in pregnant women.

Manifestations of urolithiasis in pregnant women... Doctors distinguish three mandatory symptoms:

The pain occurs in the upper part of the lower back, it can radiate to the stomach, genitals, leg. A woman is trying to take a forced position to alleviate the condition: on a healthy side, knee-elbow.

As the stone progresses, the condition may improve, but dull pain in the lower back remains. It should be noted that attacks of renal colic in pregnant women are more easily tolerated than in other patients. Perhaps this is due to the increased elasticity of tissues during the period of bearing a child.

Small stones leave almost asymptomatic and they are indicated only by traces of blood found in the general analysis of urine. The passage of stones occurs mainly before 34 weeks, then the enlarged uterus compresses the ureters and the risk of renal colic increases.

If severe pain occurs, you should immediately call an ambulance or take the pregnant woman to the emergency room of the hospital. Although the attack of colic itself does not pose a threat to the life of the mother or fetus, pain and agitation can cause spontaneous abortion or premature birth, especially in later stages.

Diagnostics

How to prevent urolithiasis?

In order to prevent the appearance of stones, healthy people need to pay attention to the prevention of urolithiasis. But these recommendations will be especially useful for those who have crystals and sand in the urine or kidney stones have been identified.

Particular attention to prevention should be paid to people whose relatives suffer from urolithiasis. Since there is a high probability that the tendency to form stones is inherited.

Can kidney stones be dissolved?

It is possible to dissolve kidney stones with medication, but not all stones lend themselves equally well to lysis.

With the help of drugs, you can dissolve:

• Uric acid stones;
• Cystine stones;
• Struvite stones;
• Phosphate stones.

Dissolution conditions

• Small diameter - stones less than 4 mm dissolve well. It is advisable to crush a stone larger than 2 cm into smaller fragments by remote or contact endoscopic crushing.
• Acid reaction of urine. Acid stones are looser and more amenable to lysis.

The duration of the dissolution period takes from 2 months to six months.

Dissolving urate stones. For dissolution are used:

Dissolution of cystine stones

• Thiopronine is a complexing agent that binds cystine. Provides dissolution of cystine stones. When taking it (800-1000 mg per day), you need to consume a sufficient amount of liquid - 2.5-3 liters. The dose is divided into 2-3 parts, taken after meals.
• Penicillamine has a similar effect, but has a greater number of side effects than thiopronine. Take 500 mg 4 times a day, one hour before meals. The last evening dose should be increased. Before going to bed, you need to take an additional 0.5 liters of water.
• Captopril binds cysteine ​​in urine and excretes it from the kidneys, preventing it from being converted to cystine. Dissolves stones gradually. Assign 20-50 mg 3 times a day, on an empty stomach.
• Drinking plenty of fluids normalizes the acidity of urine and reduces the concentration of salts.

Dissolving struvite stones

• Lithost (acetohydroxamic acid). Blocks urease, an enzyme produced by bacteria that is a constituent of struvite stones. Softens stones and leads to their crushing and excretion in the urine. Take 250 mg 3-4 times a day.

Dissolving phosphate stones. Since these calculi are formed in alkaline urine, measures are taken to dissolve them to acidify it.

• Methionine 500 mg 3-6 times a day increases the acidity of urine.
• Ammonium chloride 70-300 mg 3 times a day by mouth after meals prevents sedimentation in alkaline urine.
• Acetohydroxamic acid - 250 mg 3-4 times a day, after meals. Prescribed for urine oxidation when methionine and ammonium chloride are ineffective.
• Cranberry extract, 2 tablets 3 times a day, increases urine acidity and helps dissolve phosphates.

Drinking regimen- one of the most important components of the treatment of any type of stone. If you do not consume enough liquid, then the stones will decrease in size, but will remain in place, and then continue to grow. In addition, there is a risk of calculus formation from the salts that make up the drugs. To prevent this from happening, you need to consume up to 3 liters of fluid per day. The daily urine volume should be more than 2 liters.

To dissolve stones, it is extremely important to follow a diet and eliminate foods that increase stone formation.

The formation of kidney stones, based on medical terminology, is called urolithiasis. There is another name for this disease - "urolithiasis". Kidney stones are a tough, crystal-like mass formed from salts found in human urine. They can vary in shape, volume and weight. Some of them appear as the smallest grains, like formations, without causing pain to a person, go out through the urine, while other calculi can reach formations up to 5.6 cm in size.

Kidney stones, causes of formation

Where do kidney stones come from? There are no absolutely exact reasons for the occurrence of the described disease, however, medicine identifies some factors that can provoke the formation of kidney stones.

How kidney stones are formed, causes:

• Consumption of untreated water, with the presence of excessive amounts of salts
• this disease was inherited
• malfunctioning of functions around the thyroid glands
• excessive consumption of foods that increase the acidity of the human body: acidic food, very salty or too acidic
• also, the reason why kidney stones are formed is often an insufficient amount of ultraviolet rays
• lack of vitamin content in humans, especially for vitamins of group D
• possible illness or injury to the skeletal system. For example, osteoporosis or osteomyelitis
• long-term dehydration occurred in a person, due to poisoning or any diseases associated with infections
• ailments such as gastritis, colitis, adenoma, pyelonephritis, cystitis and other diseases of the gastrointestinal tract are other causes of kidney stones

Kidney stones also vary in composition. On this basis, they are divided into:

1. Cholesterol - detected with high cholesterol levels
2. phosphate - occur with infections of the genitourinary system
3. cystine - consist of the amino acids cystine
4. urate - salts of uric acid, are observed most often
5. oxalate - formed with alkaline urine from calcium

Having learned what kind of composition the stone has, the doctor can correctly prescribe a course of treatment for the patient.

Oxalate calcium stones

They are black or dark gray. On the calculi, pointed tubercles are formed, like thorns. Therefore, with this formation, they, moving through the internal organs, deliver strong painful sensations. The mucous membrane is damaged, as a result of which blood appears in the urine. The most common cases of their removal are with the help of an operation. More gentle treatments are only effective when you get rid of the oxalate sand.

One of the main causes of these kidney stones is over-consumption of foods high in oxalic acid.

10 main symptoms of the disease

When urolithiasis occurs, kidney function is impaired, and inflammation of the urinary tract also appears. Until the stone is in one place without movement, pain is absent. But as soon as he starts to move, very strong sharp pains appear.

Symptoms of urolithiasis:

1. Severe pain in the lumbar or side of the body
2. Aching pain of the kidney, transmitted to nearby organs
3. Lower abdomen hurts
4. The appearance of nausea, vomiting is possible
5. Infrequent or too frequent urination
6. Unpleasant sensation, possibly burning when urinating
7. Heat
8. Bowel disorders, bloating
9. High pressure
10. Cold sweat

The most important and very painful manifestation of this disease is renal colic. With her, it is difficult for a person to be in one place, a sharp contraction like pain appears. The duration of colic on average reaches a couple of hours, but there are cases that it drags on and up to a day. It can occur as numerous times in a short time, as well as once a year. At the end of colic, sand or kidney stones are often excreted in the urine.

Bloody urine with kidney stones

When a stone passes through the urinary tract, it causes damage, so blood is often present in the urine. A symptom in which blood can be seen with the naked eye is called gross hematuria.

If blood is found in laboratory tests, this symptom is called microhematuria. In 90% of cases, urolithiasis is accompanied.

Kidney stones in men

In the world, approximately every eleventh man suffers from this ailment. Urolithiasis is diagnosed more often in men than in women. The main reason for this ailment in the stronger sex is the retention of urine excretion from the body. When changes in the functions of the upper part of the urinary system are detected, the formations are located in the renal pelvis, and if changes in the lower part are found, then in the bladder. Formations from 1 to 3.5 mm usually pass freely through the urinary tract, they are usually called sand.

Kidney stones in men sometimes reach a size of 7 mm. The possibility of their free withdrawal decreases, here you may need to take an antispasmodic or diuretic. With the formation of more than 7 mm, the possibility of its elimination from the body without the intervention of doctors decreases to 6%. In such cases, urgent crushing of the pebble is necessary.

This ailment in men is marked by one sign - there is a risk of kidney stones again. According to statistics, a year later, the disease manifests itself again in 12% of men, after 2.5 years in 13%, and after 5.5 years in 43%. Urolithiasis reoccurs in all patients for a variety of reasons.

Diagnostics

Before prescribing treatment, you need to accurately diagnose. The following diagnostic methods are used:

1. Ultrasound examination
2. blood and urine tests
3. urography

The following diagnostic methods are also possible:

1. Multispiral tomography - using this method, the type and size of the pebble is revealed
2. nephroscintigraphy - detects changes in the functions of the kidney organs

The doctor necessarily interviews the patient in order to calculate the probable signs that could contribute to metabolic disorders before the formation of the disease. Based on the results of a comprehensive diagnosis, treatment is determined.

Treatment

The treatment of this ailment is divided into surgical and conservative (medications are used to crush the formations). The conservative method is possible with home treatment.

The free exit of calculi, without crushing them, is determined for each individually, it depends on the structure of the genitourinary system, on the size and shape of the stone. When formations over 9 mm appear, it is impossible to remove them without medical help.

Conservative treatments include:

• Phytotherapy
• adherence to a special diet
• stabilization of water and electrolyte balance in the body
• special treatment exercises
• physiotherapy

Necessarily prescribed medications that stop the inflammatory process, as well as diuretics, pain relieving, stone-removing drugs, are used against bacterial procedures. Treatment should be carried out exclusively under the supervision of a physician.

Dissolving kidney stones with the following medications:

• Kanephron N - herbal medicine for oxalate and urate calculi
• Phytolysin is a herbal-based drug prescribed to remove small stones
• Cyston is a drug for all types of calculi
• Blemaren, Uralit U - this medicine for kidney stones is prescribed to dissolve them. Suitable for urate and mixed stones.

With coral calculi (if the disease is accompanied by an infectious infection), it is imperative to use antimicrobial drugs to eliminate these symptoms.

Shock wave lithotripsy is recommended to break up kidney stones. This method is considered the most lightweight, because there is no need for punctures, calculi are crushed by a remote wave method, and then leave the body along with urine. This method can be used for stones no more than 2 mm.

In some difficult cases, surgical intervention cannot be avoided. There are the following types of operations:

• Open surgery - the kidney is cut and the stone is removed mechanically.
• Endourethral technique - An endoscope is inserted through a puncture into the diseased organ. Further, the calculus is destroyed either by laser or ultrasonic methods.

Before the operation, it is imperative to take medications that normalize blood microcirculation, as well as antioxidants.

Diet for kidney stones

It is imperative to minimize products fortified with oxalic acid. It is necessary to increase the consumption of foods high in magnesium (potatoes, grapes, dried apricots, etc.). Exclude overly fatty, salty and smoked foods.

When phosphate stones appear, cranberry or lingonberry juice should be included in the diet. It is advisable to stop using dairy products, herbs, vegetables altogether.

With urate stones, it is necessary to eat less meat, drink more juices from vegetables and fruits. Increase the amount of clean water taken.

Treatment with folk methods

In addition to the remedies prescribed by doctors, there is the possibility of treating the described disease with the help of traditional medicine. The most effective folk methods that help remove calculi from the body are the following:

1. It is very good to use rosehip root to crush the formations. 35 g of dried finely crushed plant must be placed in a container with two glasses of boiled water, then this broth must be infused in a water bath for 15 minutes. Next, you need to wrap the container with the broth in the material and insist for about 7 more hours. Clean the resulting tincture with a filter. It is necessary to consume this folk medicine for kidney stones thirty minutes before meals, in quantities equal to 1/2 cup. The frequency of admission is four times a day. This method has a potent effect, so the amount of time for taking this broth and individual doses should be calculated by a phytotherapist or urologist. Most often, this infusion is taken anywhere from a week to one month.
2. When forming oxalate and urate calculi, the following folk method is used. It is necessary to combine these ingredients together: lemon juice, olive oil, honey and vodka (all ingredients are taken in an amount of two hundred milliliters). This composition should be mixed well, placed in a tightly closed container and placed where it is dark and cool. It is necessary to insist for 14 days. They take this folk medicine for kidney stones three times every 24 hours for a tablespoon. After 14 days, it is necessary to take a break for 6 days, after which it is again taken for two weeks in the same amount.
3. For the next method, you need to grind ten pitted lemons with a meat grinder (do not peel off the peel). Place the resulting gruel in a large container and pour two liters of boiled water over it. Then put 2 tablespoons of glycerin there. Leave the mixture for thirty minutes, then strain. Take the infusion for two hours at intervals of 10 minutes (it turns out to drink a glass of tincture every 10 minutes). At the same time, warm up the diseased kidney with a heating pad, after a short time the pain sensations will become stronger, the sand will be excreted. When making this product, do not forget that lemon juice is a perishable product, therefore, with the subsequent use, you need to squeeze fresh juice.
4. Watermelon rinds. To use this method, it is necessary to take only watermelons grown by ourselves, in order to avoid the ingress of nitrates into the body. Cut the watermelon peels into small pieces, then dry them in the oven. Then pour water (50/50) into a container with these ingredients, and put on low heat. Boil the broth for 30 minutes. Filter and consume one glass 4.5 times every 24 hours before meals.
5. Another folk remedy is apple peel tea. Drink apple peel tea regularly and it will help get rid of stones in the kidneys, the appearance of sand and the occurrence of urolithiasis. It is only important to be treated regularly, without missing procedures. It is necessary to brew either fresh or dried watermelon skins. Although it will be more effective to grind the dried watermelon crusts into powder and then pour boiled water into a container with them. The broth is infused for 20 minutes. The amount of powder used is two teaspoons. Then just use it like regular tea.

It is better to get rid of the above-described ailment together with folk methods in conjunction with the use of medications. It is necessary to give preference to any folk remedy based on the course of treatment prescribed by the doctor.

Hello! Topic of this article "Stones in the kidneys. How are they formed and what they are. Causes. Symptoms Treatment. Prevention. Diet". We will talk about how you can help yourself if such a diagnosis is made.

But first we find out:

• what it is
• what stones are there and why do they form in the kidneys
• what are the symptoms of this disease
• why they cause unbearable pain when they go outside
• where to look for help and how to help yourself
• let's talk about prevention

Stones in the kidneys. What it is

One of the common pathologies of the urinary system is the formation of kidney stones, which, with the flow of urine through the ureters, enter the bladder. This disease is called urolithiasis (Urolithiasis).

How kidney stones are formed

Kidney stones are formed from crystals of salts, toxins, particles of the epithelium that are not dissolved in the body, not passed through the filters of the kidneys and settled in their pelvis. They can be of different sizes.

When large stones pass through the ureter, they most often either block the lumen of the ureter, or injure its walls with sharp edges. Hence, very severe pain arises. Whoever has suffered such pain at least once in his life will never be able to forget about it, and will do everything so that it does not happen again.

What are the composition of kidney stones

The whole reason is the violation of water-salt metabolism in the human body. As a result, a precipitate in the form of salt crystals precipitates in the kidneys, which, when collected together, form stones.

• Uric acid stones - formed due to the consumption of predominantly animal proteins
• Oxalate stones - most often they are found and they are the most acute in shape, which means that traumatic walls of the ureters are formed from a compound of calcium and oxalic acid, due to excessive consumption of protein foods
• Calcium Phosphate Stones - mixed from calcium sludge, phosphate salt and magnesium. Most often formed when taking predominantly plant foods
• Protein, xanthine and cysteine

Reasons for the formation of kidney stones

The following factors contribute to the formation of kidney stones:

• violation of water-salt metabolism, namely calcium and phosphorus, as well as uric acid
• violation of urine evacuation due to diseases caused by bacterial infection, mainly of the gastrointestinal tract and genitourinary system
• genetic predisposition
• endocrine diseases, especially parathyroid glands and diabetes
• food: very salty, mostly protein (both meat and vegetable origin)
• lack of vitamin A
• poor quality of the water used - hard tap water, with a large amount of mineral salts: nitrates, sulfates and chlorides
• lack of clean water intake
• lack of exercise

Stones in the kidneys. Symptoms

Symptoms or obvious signs of urolithiasis can be externally determined only if the stone began to move or it is so large that it interferes with the functioning of the kidneys. That is, depending on the size and behavior (movement) of the stones, the symptoms of the acute period of this disease can be traced. The main symptom is pain moving from the lower back to the groin. Pain varies in strength and duration.

If the stones are small enough, then together with urine they can be excreted from the body without causing any inconvenience to the person.

Larger stones on exertion cause dull, aching pain in the lumbar region. Such pain is usually mistaken for pain in osteochondrosis or radiculitis, and often people are treated on their own. If such pain is not diagnosed, then kidney stones increase in size and thereby cause inflammation of the tissue of the renal pelvis. This condition is called pyelonephritis.

Even a little physical activity can cause stones to move along the urinary tract, which clog the ureters. This causes more severe and even unbearable pain. This condition is called renal colic. You can't wait here. We need urgent medical help.

Renal colic. Symptoms

Most often, renal colic occurs early in the morning and is accompanied by:

• back pain that radiates to the groin area
• nausea and vomiting
• bloating (acute abdomen)
• cold sweat, chills
• fever (not always)
• symptoms of dehydration, or, conversely, edema
• frequent urge to urinate
• discomfort when urinating
• urine at this time is cloudy with an odor (unpleasant), often blood in the urine

It is very important not to confuse renal colic with acute surgical diseases such as acute appendicitis, acute cholecystitis, acute pancreatitis, intestinal obstruction, strangulated hernia, ectopic pregnancy, perforated stomach ulcer, duodenal ulcer. Therefore, in the presence of these symptoms, it is extremely important to urgently consult a doctor and determine the cause of the ailment as soon as possible.

In order to prevent renal colic, you need to regularly (at least once a year) undergo preventive examinations. After all, diagnosis at an early stage of the disease can save you from such painful manifestations.

Stones in the kidneys. Diagnostics

Diagnosis of the condition of the kidneys, namely the presence of stone-forming sediment (sand) or the formation of stones, can only be carried out on an outpatient basis. Today it is:

1. general clinical analysis of urine - especially pay attention to the presence of salts and which ones
2. biochemical analysis of urine with inflammatory processes in the urinary system
3. blood chemistry for the presence of uric acid
4. Kidney ultrasound- determine the presence of inclusions (sand) or stones, their size, shape, location
5. X-ray of the kidneys (intravenous urography), with the administration of a contrast agent. Thus, kidney function and urine output through the ureters and bladder are monitored. It is possible to determine the presence of phosphate and oxalate stones.
6. CT scan - determine the location of kidney stones

Stones in the kidneys. Treatment

Usually kidney stones come out with pain, but on their own. At the same time, to facilitate the advancement of the stone and the patient's condition, it is mainly prescribed to take medications:

• painkillers
• relieving spasms
• vitamins K, E and group B
• antihistamines
• sedatives

Both dry heat (hot water bottle, paraffin compresses) and hot baths help relieve the condition. But only if an accurate diagnosis is made.

In a state of remission (outside the acute period), a special diet, diuretic teas or medications, and, if necessary, anti-inflammatory drugs are recommended (to prevent the occurrence of infection if a sharp stone injures tissue).

If a large stone was found during the diagnosis and kidney function is preserved, then non-contact crushing of the kidney stone is prescribed using ultrasound - by the method of distance lithotripsy (DLT).

In an acute condition, in the case when the ureter is blocked or the stone is so large that it cannot leave on its own, its endoscopic crushing or surgical removal is indicated.

In order not to be taken to such extreme measures, it is important to engage in the prevention of kidney stones.

Stones in the kidneys. Prophylaxis

If your family has or had at least one person with urolithiasis, then you need to regularly undergo a diagnostic examination for the presence of salts, sand and stones in the body.

In the prevention of kidney stones, one of the first places is to put dietary food:

• In your menu, you need to reduce the use of fatty broths, meat and fish products rich in purines, fried and spicy foods, cocoa products, pickles and salted foods
• Meals should be frequent (5-6 times a day) and small in volume (250g)
• Sufficient drink - 30 mg per day per 1 kg of weight
• Include morning tea from diuretic and anti-inflammatory herbs in your diet

Juniper, parsley, birch leaves, cranberries, watermelon and kidney tea have a diuretic effect. All of them provide constant kidney lavage. Bearberry and lingonberry leaves relieve inflammation in the kidneys. Rosehip, cornflower, stinging nettle remove salts from the urinary tract, preventing stone formation. Chamomile, St. John's wort, coltsfoot and garlic disinfect urine, and garlic and onions also improve blood flow to the kidneys. Bearberry, violet, cranberry, juniper and lingonberry have several beneficial effects on diseased kidneys at once, so they can be drunk separately, not included in medical fees.

• Types of kidney crystals

The most common reason urolithiasis is called a metabolic disorder. Although the exact reason is still unknown. First, small formations appear, up to 3 mm, often called sand. If you do not take measures for timely diagnosis and prevention, after a certain time, treatment of kidney stones with folk remedies or with the help of traditional medicine is required. If they form in the organs of the genitourinary system, urolithiasis is called urolithiasis... If directly in the kidneys, then they talk about kidney stone disease - nephrolithiasis.

Most often, foreign inclusions occur on the right side, this is due to the anatomical features of the body. But cases of their appearance from both sides are not so rare. Formations are detected in approximately 3% of the working-age population; they affect newborns and the elderly.

Reasons for the appearance of kidney crystals

Salts in a healthy body must be completely excreted in the urine. If one or another malfunction occurs - for example, associated with metabolic disorders - its crystals begin to stick together, taking on bizarre shapes and sizes. Large are considered from 5mm and more.

As a rule, no one thinks about the existing disease, its causes and the need for treatment as long as the crystal remains motionless. When he starts to move, there is a sharp pain.

The most likely causes of the appearance of kidney formations include:

• violations of the vitamin balance, lack of ultraviolet radiation, unhealthy diet.
• deviations in the work of the parathyroid glands, causing a violation of calcium metabolism;
• geographic factor - hot climate, insufficient water intake or too hard water;
• various pathologies of the genitourinary system, congenital anomalies that cause narrowing of the urinary tract, due to which the outflow of urine is difficult;
• various diseases - pyelonephritis, hydronephrosis, prolapse of the kidneys, inflammation of the bladder, prostate adenoma, prostatitis;
• sedentary work.

Often, kidney stones have a different nature, but in more than half of the cases, their composition is mixed. They often end up in the bladder or ureter. Much is determined by the nature of the diet and the age factor.

Types of kidney crystals

The most common and at the same time the most durable stones are calcium. They are formed in the overwhelming majority of cases and are oxalate and phosphate.

Oxalate calcium stones

- black or dark gray, when moving inside the body, cause severe pain due to the surface equipped with sharp spikes. The mucous membrane is damaged and blood appears in the urine. As a rule, you have to perform their removal by operation. Other treatments can only get rid of oxalate sand.

Excessive intake of oxalic acid with food is a common cause of formation. Regular consumption of large quantities of juices, carrots, beets, vitamin C causes their formation and growth.

Phosphate Calcium Stones

- gray in color and much softer than oxalates. Their surface is smooth or slightly rough. The reason for the appearance is the shift of metabolic processes to the alkaline side. As a rule, loose flakes appear in the urine.

If you treat kidney stones with folk remedies, you need to drink sour juices, cranberry or lingonberry. Or agree to crushing done in a medical facility.

Urate stones

not detected by x-ray, detected only by urine analysis. They are composed of uric acid and have a smooth surface. Gout or regular dehydration is a common cause. Therefore, in this case, it is not very necessary to treat kidney stones with folk remedies. Drinking more water and dieting is enough to make your urine more alkaline.

Struvite stones

are the result of the activity of bacteria that process urea. Crystals of a characteristic shape resembling a coffin lid and containing magnesium are found in the urine. They are more common in women. Since it is ineffective to treat kidney stones with folk remedies or with the help of drugs, you have to go for crushing with ultrasound or a "real" operation if the formation is large enough.

Cystine (protein) stones

- appear in the case of a hereditary abnormality of metabolic processes, while in the urine there is a constantly high level of cystine. They are smooth, flat and soft and are rare. After determining the cause of the sand - hexagonal crystals - medical treatment or surgery is prescribed.

Prevention of urolithiasis and kidney stones

You need proper nutrition and drink:

• you need to drink enough clean water. Not juices - teas - compotes - soda, but pure water, especially in summer, when it's hot outside;
• it is better to exclude salt from the diet;
• limit the use of spicy, sour and fatty foods;
• do not eat dry water;
• meals should be more frequent, but in smaller portions;
• prevention implies a mandatory increase in physical activity.

Symptoms of urolitasis and nephrolitasis

Symptoms may not show up in any way until the crystals begin to move. If they have sharp protrusions, they begin to irritate the mucous membrane and cause inflammation. Often detected during routine medical examinations using ultrasound. Or when an attack of urolithiasis occurs.

The attack is preceded by various symptoms. As a rule, the lower back begins to bother, the back hurts, the pain can radiate to the legs and even cause a short lameness. There is a feeling of heaviness, it seems that you constantly have to carry something with you.

Painful symptoms may increase with physical activity or a rapid change in body position. To fall asleep, you have to pull your legs up to your stomach. When you straighten your legs at night, you have to wake up from painful sensations.

Frequent use of the toilet is a symptom of kidney disease. Emptying the bladder is painful and accompanied by the feeling that something is left in it. Blood may appear in the urine if the mucous membrane is injured.

A sign of urolithiasis is a change in the composition and color of urine. It's not just blood clots that can cause urine to darken. Often it becomes cloudy and changes its color due to a change in the chemical composition.

Diagnostics of the urolithiasis and nephrolitasis

An accurate diagnosis of kidney disease is required before treatment. It begins with laboratory tests of blood and urine. Generally, a general urinalysis is required. It is in the analyzes that there are more salts of one type or another. This allows you to diagnose the type of crystal.

Another popular diagnostic method is kidney ultrasound. The method does not require special preparation of the patient and allows detecting the location of a solid formation.

If, with the help of ultrasound, nothing was found in the kidneys, but there are suspicions of the presence of stones, a plain radiography is prescribed before treatment. The method requires bowel preparation - removal of toxins, the introduction of a cleansing enema. Calcium stones can be detected with this diagnostic method, although they are almost impossible to detect if they are from cystine.

Also, excretory urography is used, while a special compound is injected into the patient's blood, which penetrates into the kidneys and "reveals" their structure. Then the composition is completely removed from the body. During the examination, the size and shape of the formations become clearly visible.

How to eat so that you do not need to treat kidney stones with folk remedies

The nutritional system for kidney disease is determined by the chemical composition of the identified sand or stones. To avoid the intensification of the symptoms of the disease, it is necessary to help the body in every possible way by eating foods that contribute to a quick cure. Obviously, the diet should not cause an increase in the size and number of formations. On the contrary, it should contribute to their gradual dissolution and removal from the body.

Diet in case of oxalate stones

Upon detection oxalates you should stop eating foods high in oxalic acid. Even if kidney treatment is not required, but these foods make up a significant part of the daily diet, you should limit their use. Oxalic acid is found in parsley, spinach, strawberries, chocolate, wheat bran, nuts, beets, tea, and other foods.

Diet for Phosphate Stone Detection

should be aimed at acidifying urine. Drinking more cranberry or lingonberry juice is helpful for this. The treatment of formations in the kidneys of this variety is facilitated by a meat diet, the intake of sufficient quantities of fish and meat protein into the body. This should be the basis of nutrition. Greens, vegetables, milk and dairy products should be excluded.

Proper nutrition and uric acid stones

The diet should be aimed at limiting the consumption of meat, as well as by-products: liver, kidneys, brains, tongue, etc., various meat and fish broths, smoked meats, mushrooms, coffee, cocoa, chocolate.

It is useful to eat more fruits and vegetables: watermelons, melons, turnips, black currants. Shown are grape juice, strawberry, wild strawberry, rosehip, lemon.

Alternative treatment of kidney stones

Since it is possible to remove stones from the kidneys by accurately establishing their chemical composition and location using one or another diagnosis, you should not self-medicate without consulting a specialist. A popular remedy, chosen from general considerations, can harm, causing an exacerbation of urolithiasis. In especially dangerous health cases, improper self-treatment may result in an emergency operation.

Treatment of oxalate kidney stones with folk remedies

• For many, a watermelon diet helps in treatment. Within a week or two, you need to eat watermelons and some black bread. Best of all, sand is removed in the evening from 17 to 21 hours, when the daily peak of urinary system activity occurs. It is helpful to take a warm bath to facilitate the release of sand. Water relieves muscle spasm and widens the urinary tract, making the procedure much easier.
• Since it is possible to get rid of small scale stones with intensive kidney work, it is useful to drink as much liquid as possible throughout the day. You can remove them with the help of grapes, young branches and a mustache of the plant. For treatment, you need to grind 1 tsp. grape branches collected in spring, pour a glass of boiling water. Darken in a water bath or low heat for 2-3 minutes, insist and strain. Take a quarter cup four times a day.

Alternative treatment of phosphate kidney stones

• To cope with phosphate stones, infusions from the roots of plants growing on stony soils help. It could be rose hip, grape, knotweed, barberry, quarry thigh.
• You can treat kidney stones with folk remedies with a mixture of herbs: corn stigmas (2 parts), birch leaves (2 parts), juniper berries (1 part), mountaineer snake root (1 part), burdock root (1 part), steel root (1 part). One dl of a mixture of herbs is brewed in a glass of boiling water and cooked for another 15 minutes. The infusion is taken one glass three times a day.


• Phosphate stones help violet tricolor, St. John's wort, bird's wort, larkspur, dandelion roots... The herbs are mixed in equal proportions. Five tablespoons of the mixture is brewed with a liter of boiling water, infused. Treatment is performed by taking one glass of infusion three times a day.

How to treat urate stones with oats and herbs

• When urate stones are formed, it is useful to be treated with oats. Namely, take the following folk remedy daily. Oat grains in husks are taken, washed, poured into a thermos and poured with boiling water. After 10-12 hours, the oats need to be rubbed through a fine sieve. The resulting gruel is eaten for breakfast, preferably without adding salt and sugar.
• To treat kidney stones with folk remedies in case of excess uric acid, you can use a mixture of highlander herbs (1 part), currant leaves (2 parts), strawberry leaves (2 parts). The herbs are mixed, one tablespoon of the mixture is brewed with a glass of boiling water. After the infusion is filtered. Take 2 tbsp. infusion one hour before meals 3-4 times a day.

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The method "wait until the problem is resolved by itself"

Small rounded calculi are able to leave the kidneys themselves. This usually takes 4 to 6 weeks. The main thing is that the stone is small enough and does not block the urinary tract. If the formations do not have sharp protrusions, as in uric acid calculi, then the process is accompanied by rather bearable pain. The main self-help for kidney stones is to drink enough water, and if you feel discomfort from passing them, take antispasmodic and pain relievers.

Drug treatment

Learn how to treat kidney stones with stone-dissolving drugs in this article.

Other areas of therapy:

• elimination of an attack of renal colic;
• promoting the allocation of small stones;
• the fight against relapses.

At home, a warm bath or heating pad along the ureter can relieve pain when sand and larger formations pass. Medically, an attack of renal colic is removed by injection of antispasmodics Aropin or Platyphyllin, pain syndrome is eliminated by Promedol, Morphine, Pantopol.

The use of novocaine blockade is also effective. In men, it is carried out by injecting a solution of novocaine into the thickness of the spermatic cord, and in women - into the round ligament of the uterus. They also relax the ureter by means of novocaine blockade of the lumbar region.

Essential oils, especially terpene derivatives, contribute to the expulsion of stones. The most commonly used drugs are Olimetin, Enatin. Their action is due to the analgesic, antispasmodic and stimulating effect on the urinary tract. In addition to stimulating urodynamics, these drugs increase the content of protective colloids in the urine, which prevents new stone formation.

Physical methods

In the case when the stones are quite large and it is impossible to ensure their dissolution and spontaneous exit, they are treated with the help of various devices and instruments.

There are different localizations of calculi. The first is in the internal structures of the kidney and the second is in the ureter.

Treatment of ureteral stones

Ureteral calculi are attempted to be removed using a ureteral catheter. There are several types of boats and how to use them.

• The catheter is passed past the stone and petroleum jelly or glycerin is injected above its location. This promotes the sliding of the calculus and enhances the peristalsis of the ureter. Often, when the catheter is removed, the stone easily comes out with it.
• Try to expand the ureter below the calculus. For this, a catheter with an inflatable balloon of the Durmashkin system is used, which creates the necessary lumen in the ureter.
• The stone is captured with a Zeiss loop catheter and removed from the ureter.

Kidney stone

The methods of removing kidney stones that exist today can be arranged in the following order of preference for choice:

• extracorporeal lithotripsy (shock wave);
• contact endoscopic lithotripsy (laser, compressed air or ultrasound);
• transurethral removal;
• percutaneous nephrolithotomy or nephrolithotripsy;
• laparoscopic removal;
• open organ operations.

Extracorporeal shock wave lithotripsy

Shock wave lithotripsy is a non-surgical technique used to treat kidney and ureteral stones. The shock wave application is monitored using X-rays or ultrasound. The method is effective for crushing formations no more than 2 cm in size. Cystine stones, some types of oxalate and calcium phosphate are also difficult to influence.

Description of the procedure

The patient is placed in a water bath or a pillow filled with water is placed on the stomach or on the lumbar side.

Before crushing, local anesthesia or sedation is possible so that the patient can calmly endure the procedure, which lasts up to an hour.

Impact on calculi occurs by focusing an acoustic wave on them, which spreads well in a liquid medium and does not damage body tissues.

A stent is inserted through the bladder into the ureter, which keeps the lumen open. This is necessary to allow fragmented parts to escape and prevent blockage of the ureter.

After the procedure, the patient will be asked to drink a lot of fluids, and filter the urine through a filter to collect the released calculi for analysis.

Although this method is considered very safe, it can still cause some side effects. For example, the appearance of blood in the urine within a few days after the procedure. Pain and spasms from the passage of stone fragments through the ureter are also possible.

The method is effective in 50-70% of cases if the formations are in the kidneys and are small in size. The method is not entirely suitable for crushing stones in the ureters, since the shock wave is extinguished by the vertebrae or pelvic bones surrounding the ureter. For this purpose, it is better to choose another method. For example, ureteroscopy.

Contact laser lithotripsy

Removal of kidney stones with a laser was tested in the late nineties. But then the apparatus was very bulky and expensive. Today, contact laser removal of kidney stones is carried out using the thinnest beam - a horse hair diameter, and the operation is called transurethral laser ureterolithotripsy.

The operation takes about an hour and is performed under general anesthesia. First, the attending physician runs a flexible guiding string along the urinary tract up to the stone. Then a ureteroscope is inserted with a camera and a thinnest laser light guide at the end. Now, under visual control, the doctor begins to destroy the calculi with a laser, and the chipped pieces are absorbed by the apparatus.

After the operation, a dilator is also inserted into the ureter for the natural release of dust and sand remaining after crushing.

The procedure carries a small risk of bleeding, since in 1-2% of patients, damage to the ureteral mucosa is possible.

The recovery period is usually a day or two. Unfortunately, every third patient may have recurrent calculus within ten years. To prevent this, after the operation, it is imperative to adhere to a diet and drinking regimen.

The main indications for laser destruction are:

• large size of formations that are not amenable to shock wave therapy;
• stones are in the ureter.

Contraindications for this operation:

• pregnancy;
• infectious and inflammatory diseases of the urinary tract or its physical damage;
• renal bleeding;
• narrowing of the ureter in a large segment.

Ureteroscopy (transurethral removal)

Ureteroscopy is used preferably for the treatment of stones located in the ureter. It involves passing a very thin telescope (ureteroscope) through the bladder to the ureter and kidney. Rigid telescopes are used in the lower part of the ureter near the bladder. Flexible telescopes are used to treat the upper ureters and kidneys.

The procedure is performed under general anesthesia for the patient's comfort and safety. The ureteroscope allows the urologist to see the stone without making an incision. A manipulator combined with the telescope grabs it and brings it out. If the education is too large, in order to remove it entirely, then it must first be broken using a laser or other methods.

A temporary stent is also placed to ensure that sand and stone parts can flow freely. The period of wearing the stent should not exceed 4-10 days, otherwise there is a risk of infection and loss of kidney function.

Percutaneous nephrolithotripsy

This type of treatment is the method of choice in the presence of large aggregates larger than 2 cm; coral stones; abnormal structure of the urinary tract; obese patient.

The procedure is performed under general anesthesia. A guidewire is inserted through an incision in the skin in the lumbar region under X-ray control, and then a special endoscopic apparatus, a nephroscope, is installed along it. Basically, it is a hard or soft tube with lighting and video systems. Through the internal channel of the nephroscope, a lithotripter can be inserted into the body cavity - the actual apparatus that removes stones from the kidneys with ultrasound, compressed air or a laser. Having visually detected a kidney stone, the doctor destroys it with a lithotripter, and the fragments are removed outside. In various clinical situations, it may be necessary to place a nephrostomy tube or stent into the ureter. These devices ensure the normal flow of urine during the first time after surgery.

Of the complications, attention is paid to the infectious process (prevented by taking antibiotics on the eve of the operation), possible mechanical damage to blood vessels and tissues. As with any crushing method, the remains of stone fragments are possible.

Contraindications are pregnancy and a violation of the blood coagulation system, and in other cases, percutaneous nephrolithotripsy is considered the gold standard of treatment.

Laparoscopic pyelolithotomy

The operation to remove kidney stones is performed through small incisions into which a video system and manipulators (trocars) are installed. The technique of the procedure requires cutting the parenchyma of the kidney and pelvis, which are sutured after removing the stone. If necessary, a pelvic or ureteral stent is placed. The calculus is brought out through the trocar openings. The recovery period is longer than that of non-invasive methods - up to 4 days. But in comparison with surgical intervention on an open organ, laparoscopy is less traumatic.

Kidney stones are removed laparoscopically in such cases:

• abnormalities of the urinary system do not allow the use of endoscopic methods;
• severe obesity.

Like all methods of removing stones from the kidneys, laparoscopy has contraindications for an infectious disease, a violation of blood clotting, an acute inflammatory process of the genitourinary system. As well as the presence of scarring from previous operations, which can prevent the installation of equipment in the right place in the abdominal cavity.

Surgical removal of stones

Surgery to remove kidney stones on an open organ is indicated only in some cases. Since it involves an incision in the parenchyma of the kidney, this negatively affects its condition and functionality. So, you can't do without an operation if:

• The pain is too severe for the patient to wait until it goes away.
• The stone causes an acute blockage of the pelvis. Anuria and urosepsis develop.
• Concretions cause recurrence of urinary infection. By provoking stagnation of urine, they create conditions for chronic pyelonephritis and the development of renal failure.
• The stone affects the function of the kidneys, triggers a change in the parenchyma.

The following cases are not subject to surgical intervention:

• Stones in the kidney cup. They have little effect on the functionality of the kidney, are often prone to relapse, but they can also spontaneously excrete first into the pelvis, and then into the ureter.
• Patients with a tendency to frequent stones. For them, it is rational to operate only on large stones that are incapable of independent discharge.
• Coral stones in one kidney. They are motionless, fill the pelvis and, in principle, the kidney remains relatively functional.

Principles of stone surgical treatment

• With a combination of formations in the cups and the pelvis, the pelvis stone is removed first.
• It is not rational to remove multiple stones in cups that cause severe pain. It will be about removing the kidney.
• In case of damage to both kidneys, operations are performed in two stages. First, stones are removed from the less affected organ, and then, when it recovers, from the more affected.
• The presence of stones in a single kidney and its ureter is an immediate indication for surgery.

It should be remembered that even after successful treatment of kidney stones, relapse may occur over time. To prevent it, you should follow a diet adequate to water load, regularly take urinalysis and undergo an ultrasound examination or X-ray of the kidneys.

2pochki.com

Causes of urolithiasis - Why kidneys hurt

1. Violation of water-salt metabolism
2. Violation of acid-base balance (a healthy person has slightly acidic urine, pH 5.8-6.2)
3. Mineral-laden food, hard water
4. Stagnation of urine
5. Infection in the kidneys, inflammation in the mucous membranes of the kidneys
6. Prolonged dehydration of the body

Kidney stones - symptoms - How kidneys hurt

Symptoms of kidney stones depend on where the stones are located: in the kidney, ureter, or bladder
Symptoms of the location of kidney stones
1. Back pain, aggravated by shaking, physical exertion
2. If the stone is in the kidney and blocks the path of urine outflow from the renal pelvis, then the symptoms of urolithiasis may be: an attack of renal colic, nausea, vomiting, fever, cold sweat.

Symptoms when located in the ureter

1. Pain in the genital or groin area
2. Frequent urge to urinate

Symptoms of the location of stones in the bladder

1. Irritation and inflammation of the mucous membrane of the bladder
2. Painful and frequent urination
2. Bleeding if stones severely injure the mucous membrane.

What are kidney stones with urolithiasis

Urate stones are formed in people with very acidic urine. They are solid, their color is yellowish-brown, they do not dissolve in an acidic environment. Urates are absorbed at pH 6.2 and above, i.e. in an alkaline medium. The acidification of the body and the formation of urates occurs if the following foods are often found in the diet: meat, rich broths, eggs, sausages, fried, smoked, flour, coffee.

Oxalate stones- the most common, found in 85% of the population. Oxalates have a gray-yellow color and a spike-like structure, they easily injure the mucous membrane, therefore, with these stones, the kidneys hurt the most and the symptoms are more pronounced. They are formed from calcium oxalate when the metabolism of oxalic acid is disturbed. Often, oxalates strike adherents of a healthy lifestyle, since they arise in lovers of citrus juices, tomatoes, carrots, beets and vitamin complexes, especially ascorbic acid. This species is also formed in an acidic environment, with a pH of 5.3-5.7

Phosphate stones- This species is often found in older vegetarians. Their surface is smooth, soft texture, light gray color. Phosphate stones occur when the kidneys excrete excess calcium and phosphorus, which often occurs when the acid-base balance in the body shifts to the alkaline side, i.e., at pH values ​​above 6.2. A symptom of phosphate kidney stones is whitish-friable flakes in the urine. You can dissolve and remove phosphates from the kidneys with acidic mineral waters: "Arzni", "Sairme", "Truskavets", cranberry or lingonberry fruit drinks. Phosphate kidney stones grow quickly, break easily

Carbonate stones formed from calcium salts of carbonic acid. They are white, smooth and soft. This species also forms in alkaline urine.

Other types of stones: cystine, xanthine, protein, cholesterol. They are quite rare.

Prevention of urolithiasis
In order not to get sick with urolithiasis, you need to drink as much water as possible. 1.5 liters of water per day is enough only for basic metabolism, but not enough for filtration, washing the viscera and removing toxins. It is advisable to consume 2.5 liters of water per day. To prevent kidney stones, you need to reduce the amount of fatty, fried, spicy and salty foods. It is necessary to try to avoid infectious diseases of the bladder and kidneys, and in case of illness, do not leave the disease untreated

Kidney stones - diet for urolithiasis - nutrition

Diet for urolithiasis plays a very important role in the treatment of the kidneys. The selection of the diet depends on the type of stones and on the reasons that caused the urolithiasis in a particular case. A diet for urolithiasis excludes from the patient's diet foods that cause the growth and formation of new kidney stones.
When treating the kidneys with a diet, the fact that all stones are divided into two groups is taken as a basis: alkaline (phosphates and carbonates) and acidic (urates and oxalates).

Diet for phosphate kidney stones
If phosphate stones have formed, then the urine has an alkaline reaction, it is necessary to acidify it. Many vegetables, fruits, milk give an alkaline reaction, so it is necessary to reduce their share in the diet and increase the consumption of meat, fish, flour products and vegetable oil, which acidify urine. The diet for phosphate stones should include acidic mineral waters, cranberry or lingonberry juice.

Diet with carbonate stones
If urolithiasis is caused by carbonate stones in the diet, calcium-rich foods are limited: milk, kefir, cheese, yoghurts, cottage cheese. The rest of the diet is similar to the phosphate diet.

Diet for uric acid kidney stones
If urolithiasis is caused by urate stones, then exclude products that contribute to the formation of uric acid in the body (liver, kidneys, meat broths). In the diet, they limit foods that contribute to the acidification of the body: meat, eggs, fish, vegetable oil. Such patients are recommended dishes that alkalize urine: potatoes, pumpkin, cucumbers, watermelons, cereals.

With urate stones, a watermelon diet is very effective: on the first day, eat 3 kg of watermelon and a loaf of black bread. This procedure will cleanse the intestines well. On the second day, repeat the procedure - this will reduce the size of kidney stones. The watermelon diet should be carried out during the entire watermelon season - 2 days a week.
The diet for urolithiasis with urate stones must include alkaline mineral waters: "Naftusya", "Essentuki" No. 17 and No. 20, "Borzhomi", "Slavyanovskaya"

Diet for oxalate kidney stones
If urolithiasis is caused by oxalate stones, then kidney treatment should be combined with limiting the use of foods rich in oxalic acid: spinach, sorrel, potatoes, lettuce, oranges and milk. The diet should include apples, pears, grapes, dried apricots, as well as dishes with a high content of magnesium, which binds oxalic acid salts.

For all types of stones in the diet, you must adhere to the following recommendations:

1. Increase the volume of fluid intake to 2.5 liters per day
2. Regularly take diuretic herbal infusions
3. Do not overeat, avoid fatty, fried, smoked foods and excess salt in the diet

How to treat kidney stones - recipes of the newspaper "Vestnik HLS"

How to treat kidney with oats

The man was diagnosed with urolithiasis. He bought a bucket of oats and drank oat broth instead of water for 4 months. A year later, he again did an ultrasound scan and no sand or kidney stones were found. (HLS 2009 No. 6 p. 33)

Another similar recipe The following folk recipe will help to cure the kidneys from sand or stones: Grind unpeeled oats in a coffee grinder, take half a glass per 1 liter of water, boil for 5 minutes, let it brew for 5-6 hours. Drink a liter of broth for three days. Sand will begin to come out.

To consolidate the effect and remove the remaining sand, you need to drink the following infusion: bearberry and blueberry leaves, bean pods, knotweed in equal proportions. 1 tbsp. l. pour 0.5 liters of boiling water into the mixture, leave for 1 hour, take 1/3 cup 3 times a day. To heal the kidneys with these herbs - 3-6 months (HLS 2010, No. 8 p. 30)

How to treat kidneys with knotweed and other folk remedies

From conversations with Klara Doronina
To cleanse the kidneys from sand: 10 g of dry knotweed herb per 200 g of boiling water - infuse overnight. Drink 50 g + 1 tsp. lemon juice 4 times daily before meals. The course is 27 days. So that the sand does not injure the mucous membrane, after eating, at intervals of an hour, drink 150 g flaxseed jelly (1 tablespoon of flaxseed pour 0.5 liters of boiling water, cook for 10 minutes).

If the kidneys are no longer sand, but pebbles, at the first signs of illness, drink knotweed decoction for six months. Knotweed has a diuretic effect and removes potassium, calcium, magnesium from the body. Therefore, at the same time as taking it, apply asparkam or panangin.

If the disease is already running, tormenting uric acid diathesis, the body works on the production of stones, attacks of their discharge more and more often, and have already given the disability of the second group, that is, a way to break out of this vicious circle. You need to prepare 2 kg of dry knotweed herb, 5 kg of flaxseed, 40 tsp. from powder from films of chicken stomachs (remove the film from raw stomachs, dry in a warm oven until crunching, grind), 2 packs of calamus root (100 g). Make a flat pillow from flax seeds, sleep on it on your back for 2 months. Before starting kidney treatment with folk remedies, brew 50 g of calamus root with three liters of boiling water for two days, leave for 24 hours.

The day before treatment: drink 30 g of infusion every two hours. It is normal for the stool to become runny.
Treatment of kidney stones: on an empty stomach, drink 30 g of infusion, then 1 tsp. put the powder from the films in your mouth, wash down with calamus infusion. After half an hour, drink 170 g of knotweed infusion (2 tablespoons per 500 ml of boiling water), after another half hour, take 15 drops of cystenal or urolesan. And two more times a day before meals, take an infusion of knotweed and cystenal in this sequence. The course of treatment of the kidneys with folk remedies is 10 days. Break for 5 days, during these five days, take an infusion of calamus root, 30 g every 2 hours. Conduct four courses. (HLS 2004 No. 2 p. 19)

"Seven herbs - seven weeks" - treatment of the kidneys by the method of V. I. Nekhaev

In folk remedies for the treatment of kidneys, herbs play an important role; without the use of herbs, it is impossible to cure urolithiasis and modern medications. The technique described below allows you to expel stones, reduce them in size and even completely dissolve.

The first week is bearberry. 1 tbsp. l. bearberry is poured with 1 glass of boiling water, boil in a water bath. 20 minutes. Drink 4 times a day for 50 g. In hot weather, increase the amount of broth to 75 g per dose.
Second week - field horsetail. The dosage, preparation and dosage regimen are the same. For more, a new herb is used every week in succession: dill, parsley, lingonberry leaf, calendula petals, bird knotweed (knotweed).
Against the background of this treatment, the volume of fluid you drink should be at least 1.5 liters, and in the summer - 2.5 liters (HLS 2004 No. 14, p. 15)

How to treat kidneys with watermelons

In folk remedies for the treatment of kidney diseases, the method of treatment with watermelons is used with great success. This is a time-honored recipe. Watermelons should be nitrate-free.

Before treatment with watermelons, it is advisable to cleanse the intestines for two weeks with enemas with lemon juice (for 2 liters of boiled water with a temperature not exceeding 18 degrees 1 tbsp. L. Juice). Then start treatment: instead of water - there is a cart, instead of food - there is a watermelon with black bread. Follow this diet for two weeks. Do not take any other food during this time.

The results are great. In most patients, stones come out, the kidneys are cleared of existing layers, wrinkles are smoothed, excess weight goes away. (HLS 2004, No. 14, p. 15. From a conversation with the chief physician of the Moscow City Clinical Hospital No. 54 Nakhaev V. I.))

Alternative treatment with rosehip root

A large kidney stone went down the ureter of the woman. They took her to the hospital and began to prepare for the operation. The husband of this woman dug up rosehip roots, then made decoctions from it: 8 tbsp. l. root, pour a liter of boiling water, boil for 15 minutes. The woman drank this broth 6-8 times a day for 100 g. She drank it for two days, on the third day a stone came out of the kidney, a week later another - light and friable, 7 mm in size. A month later, hard stones of dark red color came out. (2001, No. 20 p. 17-18,)

narrecepti.ru

The process of stone formation and types of calculi

The formation of kidney stones occurs as a result of a complex physicochemical process with violations of the colloidal balance and changes in the renal parenchyma.

Under certain conditions, a so-called elementary cell is formed from a group of molecules - a micelle, which serves as the initial nucleus of a future calculus. The "building" material for the nucleus can be amorphous sediments, fibrin filaments, bacteria, cell detritus, foreign bodies present in the urine. Further development of the stone formation process depends on the concentration and ratio of salts in urine, urine pH, qualitative and quantitative composition of urinary colloids.

Most often, stone formation begins in the renal papillae. Initially, microliths are formed inside the collecting tubules, most of which are not retained in the kidneys and are freely washed out in urine. When the chemical properties of urine (high concentration, pH shift, etc.) change, crystallization processes occur, leading to a delay in microliths in the tubules and incrustation of papillae. In the future, the stone can continue to "grow" in the kidney or descend into the urinary tract.

According to the chemical composition, several types of kidney stones are distinguished - oxalate, phosphate, urate, carbonate, cystine, protein, cholesterol, xanthine. Oxalates are composed of calcium salts of oxalic acid. They have a dense structure, black-gray color, prickly uneven surface. Oxalate kidney stones can form with both acidic and alkaline urine.

Phosphates are calculi composed of calcium salts of phosphoric acid. In consistency, they are soft, crumbly, with a smooth or slightly rough surface, whitish-grayish in color. Phosphate kidney stones are formed with alkaline urine, grow rather quickly, especially in the presence of infection (pyelonephritis).

Urates are represented by crystals of uric acid salts. Their structure is dense, the color is from light yellow to brick-red, the surface is smooth or small-dotted. Uric acid kidney stones occur with acidic urine. Carbonate calculi are formed during the precipitation of calcium salts of carbonic (carbonate) acid. They are soft, light, smooth, and can have various shapes.

The composition of cystine stones contains sulfur compounds of the amino acid cystine. The calculi have a softish consistency, smooth surface, rounded shape, yellowish-white color. Protein stones are formed mainly by fibrin with an admixture of bacteria and salts. These kidney stones are soft, flat, small in size, and white. Cholesterol kidney stones are rare; are formed from cholesterol, have a soft crumbling consistency, black in color.

Sometimes stones are formed in the kidneys not of a homogeneous, but of a mixed composition. One of the most difficult variants of kidney stones are coral kidney stones, which make up 3-5% of all calculi. Coral-shaped kidney stones grow in the pelvis and in appearance represent its cast, almost completely repeating the size and shape.

Reasons for the formation of kidney stones

Stone formation is based on the processes of crystallization of urine saturated with various salts and the deposition of crystals on a protein matrix-core. Kidney stone disease can develop in the presence of a number of concomitant factors.

Disorders of mineral metabolism leading to the formation of kidney stones can be genetically determined. Therefore, people with a family history of nephrolithiasis are advised to pay attention to the prevention of stone formation, early detection of calculi by monitoring the general analysis of urine, undergoing ultrasound of the kidneys and ultrasound of the bladder, observation by a urologist.

Acquired disorders of salt metabolism, leading to the formation of kidney stones, can be due to external (exogenous) and internal (endogenous) causes.

Among the external factors, the greatest importance is given to climatic conditions and the drinking regime and diet. It is known that in hot climates with increased sweating and a certain degree of dehydration of the body, the concentration of salts in the urine increases, which leads to the formation of kidney stones. Dehydration of the body can be caused by poisoning or an infectious disease that occurs with vomiting and diarrhea.

In the northern regions, the factors of stone formation can be a deficiency of vitamins A and D, a lack of ultraviolet radiation, the predominance of fish and meat in the diet. Drinking drinking water with a high content of lime salts, food addiction to spicy, sour, salty also leads to alkalization or acidification of urine and precipitation of salts.

Among the internal factors that contribute to the formation of kidney stones, first of all, there is a hyperfunction of the parathyroid glands - hyperparathyroidism. The increased work of the parathyroid glands increases the content of phosphates in the urine and the leaching of calcium from the bone tissue. At the same time, the concentration of calcium phosphate salts in the urine increases significantly. Similar disorders of mineral metabolism can occur in osteoporosis, osteomyelitis, bone fractures, spinal injuries, spinal cord injuries, accompanied by prolonged immobility of the patient, bone loss, impaired urinary tract emptying dynamics.

Endogenous factors in the formation of kidney stones also include gastrointestinal diseases - gastritis, peptic ulcer, colitis, leading to a violation of acid-base balance, increased excretion of calcium salts, weakening of the barrier functions of the liver and changes in the composition of urine.

In the pathogenesis of the formation of kidney stones, a known role belongs to unfavorable local conditions in the urinary tract - infections (pyelonephritis, nephrotuberculosis, cystitis, urethritis), prostatitis, kidney anomalies, hydronephrosis, prostate adenoma, diverticulitis and other pathological processes that disturb the passage of urine.

Slowing down the outflow of urine from the kidney causes stagnation in the calyx-pelvis system, oversaturation of urine with various salts and their precipitation, delay in the passage of sand and microliths with urine. In turn, the infectious process developing against the background of urostasis leads to the ingress of inflammatory substrates into the urine - bacteria, mucus, pus, protein. These substances are involved in the formation of the primary nucleus of the future calculus, around which salts crystallize, which are present in excess in the urine.

Kidney stone symptoms

Depending on their size, quantity and composition, kidney stones can produce symptoms of varying severity. A typical clinic of nephrolithiasis includes back pain, the development of renal colic, hematuria, pyuria, and sometimes - spontaneous passage of a kidney stone with urine.

Lower back pain develops as a result of a violation of the outflow of urine, can be aching, dull, and with a sharp urostasis, with blockage of the kidney pelvis or ureter with a stone, it can progress to renal colic. Coral-shaped kidney stones are usually accompanied by a mild dull pain, and small and dense ones give a sharp paroxysmal pain.

A typical attack of renal colic is accompanied by sudden sharp pain in the lumbar region, spreading along the ureter into the perineum and genitals. Reflexively, against the background of renal colic, frequent painful urination, nausea and vomiting, flatulence occur. The patient is agitated, restless, unable to find a position to relieve the condition. A painful attack with renal colic is so pronounced that it is often stopped only by the introduction of narcotic drugs. Sometimes, with renal colic, oliguria and anuria, fever develop.

At the end of an attack of renal colic, sand and stones from the kidneys are often excreted in the urine. When passing, stones can injure the mucous membrane of the urinary tract, causing hematuria. More often mucosal damage is caused by pointed oxalate calculi. With kidney stones, the intensity of hematuria can be different - from minor erythrocyturia to severe gross hematuria. Discharge of pus in the urine (pyuria) develops when there is inflammation in the kidneys and urinary tract.

The presence of kidney stones does not manifest itself symptomatically in 13-15% of patients. In this case, as a rule, pyelonephritis and morphological changes in the kidneys are absent.

Diagnosis of kidney stones

Recognition of kidney stones is based on history, a typical picture of renal colic, laboratory and instrumental imaging studies.

At the height of renal colic, there is a sharp pain on the side of the affected kidney, a positive Pasternatsky symptom, painful palpation of the corresponding kidney and ureter. The study of urine after an attack reveals the presence of fresh erythrocytes, leukocytes, protein, salts, bacteria. Biochemical examination of urine and blood to a certain extent makes it possible to judge the composition and causes of the formation of kidney stones.

Right-sided renal colic must be differentiated from appendicitis, acute cholecystitis, and therefore an abdominal ultrasound may be required. With the help of ultrasound of the kidneys, anatomical changes in the organ, the presence, localization and movement of stones are assessed.

The leading method for detecting kidney stones is X-ray diagnostics. Most of the stones are determined already with plain urography. However, proteinaceous and uric acid (urate) kidney stones do not retain the rays and do not give shadows on the plain urograms. They must be identified using excretory urography and pyelography. In addition, excretory urography provides information about morpho-functional changes in the kidneys and urinary tract, the localization of calculi (pelvis, calyx, ureter), the shape and size of kidney stones. If necessary, urological examination is supplemented with radioisotope nephroscintigraphy, MRI or CT of the kidneys.

Kidney stones treatment

Treatment of nephrolithiasis can be conservative or operative and in all cases is aimed at removing stones from the kidneys, eliminating the infection and preventing the recurrence of calculi.

With small kidney stones (up to 3 mm), which can be removed independently, an abundant water load and a diet that excludes meat and offal is prescribed. For urate stones, a dairy-plant diet is recommended, alkalizing urine, alkaline mineral waters (Borjomi, Essentuki); with phosphate calculi - taking acidic mineral waters (Kislovodsk, Zheleznovodsk, Truskavets), etc. Additionally, under the supervision of a nephrologist, drugs that dissolve kidney stones, diuretics, antibiotics, nitrofurans, antispasmodics can be used.

With the development of renal colic, therapeutic measures are aimed at relieving obstruction and painful attack. For this purpose, injections of platifillin, metamizole sodium, morphine or combined analgesics in combination with a solution of atropine are used; a warm sitz bath is carried out, a heating pad is applied to the lumbar region. With intractable renal colic, novocaine blockade of the spermatic cord (in men) or the round ligament of the uterus (in women), ureteral catheterization or dissection of the ureteral orifice (in case of calculus infringement) is required.

Surgical removal of kidney stones is indicated for frequent renal colic, secondary pyelonephritis, large stones, ureteral strictures, hydronephrosis, kidney blockade, threatening hematuria, single kidney stones, coral stones.

In practice, for nephrolithiasis, a non-invasive method is often used - distance lithotripsy, which allows you to avoid any interference in the body and remove stone fragments from the kidneys through the urinary tract. In some cases, an alternative to open surgery is a high-tech procedure - percutaneous (percutaneous) nephrolithotripsy with lithoextraction.

Open or laparoscopic interventions for the extraction of kidney stones - pyelolithotomy (dissection of the pelvis) and nephrolithotomy (dissection of the parenchyma) - are resorted to in case of ineffectiveness of minimally invasive surgery. With a complicated course of kidney stones and loss of kidney function, nephrectomy is indicated.

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