Renal Calculi

Kidney stones (renal calculi) are hard, crystalline mineral material formed within the kidney or urinary tract.

  • Stones in kidneys—Nephrolithiasis
  • Stones in urinary tract—Urolithiasis
  • Stones in ureters–Ureterolithiasis

Causes—-

  • Hyper excretion of relatively insoluble urinary constituents
    1. Oxalates
    2.  Calcium
    3. Uric acid
    4.  Cysteine
    5. Magnesium trisilicate
        1.  

  • Physiological changes in urine
  1. Urinary pH
  2. Colloid content
  3. Decreased concentration of crystalloids
  4. Urinary magnesium/calcium ratio.
  • Altered urinary crystalloids and colloids
  1. Increase in the crystalloid level
  2. Fall in the colloid level
  3. Loss of solvent action of colloids
  4. Loss of adhesive property of colloids
  • Decreased urinary output of citrate
  • Hyperparathyroidism
  • Nidus of stone formation
  • Prolonged immobilization
  • Urinary infection
  • Urinary stasis
  • Vitamin A deficiency

 Types—

  • Calcium stones

Calcium can combine with other substances, such as oxalate, phosphate, or carbonate to form the stone

  • Cystine stones

This disorder runs in families and affects both men and women.

  • Struvite stones

Common in women with UTI. These stones can grow very large and block the kidney, ureter, or bladder.

  • Uric acid stones

They occur with gout or chemotherapy

Symptoms And Signs–

  • Pain
  1. Severe and sudden
  2. Felt in the belly area or side of the back
  3. Move to groin or testicles
  4. Fixed(ureteric colic/referred pain)
  • Abdominal distension
  • Chills
  • Diminished peristalsis
  • Fever
  • Haematuria
  • Hydronephrosis
  • Muscle rigidity over the kidney
  • Nausea
  • Pyuria
  • Swelling in the flank
  • Tenderness (renal angle posteriorly)
  • Vomiting

Investigations–

  • Blood examination
  • Urinalysis
  • Radiography
  1. Straight X-ray
  2. Excretory urogram
  • Ultrasonography
  • Computed tomography
  • Renal Scan
  • Cystoscopy
  • Stone Analysis

Treatment–

                 Kidney stones that are small enough usually pass on their own

  • Self-Care

Drink at least 6 – 8 glasses of water per day to produce a large amount of urine. Some people might need to get fluids through vein (intravenous).

  • Ayurvedic Medicines provide quick and complete cure.
  • Surgery-
  1. Lithotripsy (shock wave lithotripsy)
  2. Endoscopic treatment
  3. Percutaneous removal (PCNL)
  4. Laparatomy

Complications—

  1. Decrease or loss of function in the affected kidney
  2. Kidney damage
  3. Scarring
  4. Acute unilateral obstructive uropathy
  5. Recurrence of stones
  6. Urinary tract infection

Prevention—

  1. Drink more water (8 to 10 glasses per day).
  2. Dietary changes –Avoid calculi forming foods, such as those high in purines, calcium.

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