What causes kidney stones | Kidney Stones: Types, Diagnosis,
What causes kidney stones Small stones may be asymptomatic, but large stones cause excruciating pain in the area of the back between the ribs and the hip.
Imaging tests and a urinalysis are usually performed to diagnose stones.
Sometimes stone formation can be prevented by changes in diet or by increasing fluid intake.
Stones that fail to pass by themselves are removed with lithotripsy or by an endoscopic technique.
Urinary tract stones begin to form in a kidney and may increase in size in a ureter or in the bladder. Depending on where the stone is located, it is called a kidney stone, ureteral stone, or bladder stone. The process of stone formation is called urologists, kidney stones, or pyelonephritis. What causes kidney stones
Each year, about 1 in 1,000 adults in the United States is hospitalized for urinary tract stones. Stones are more common in middle-aged and older adults.
The size of the stones ranges from those that are so small that they cannot be seen with the naked eye to 2.5 cm in diameter or more. A large stone, a so-called staghorn stone (also called a staghorn calculus because of its multiple ramific
What causes kidney stones
ations shaped like this), can fill almost the entire renal pelvis (the central collecting chamber of the kidney) and the ducts leading to it. in it (chalices)
A urinary tract infection can occur from the growth of bacteria trapped in stagnant urine at the site of the blockage.
Types of calculations
Stones are made up of minerals present in the urine that form crystals. Sometimes crystals grow inside the stones. About 85% of stones are composed of calcium, and the rest are made up of various substances, including uric acid, cystine, or struvite. Struvite stones (a mixture of magnesium, ammonium, and phosphate) are also called infection stones, because they only for
- Citrate is an inhibitor because it normally binds to calcium, which is often involved in stone formation.
- In rare cases, drugs (including indinavir ) and substances in the diet (for example, melamine) cause stones.
Stones, especially tiny ones, can be asymptomatic.
Those that obstruct the ureter, the renal pelvis or any of the evacuation ducts of the kidney, produce back pain or renal colic. Renal colic is characterized by excruciating and intermittent pain, usually localized in the area between the ribs and the hip,
Extending through the abdomen and often to the genital area. Pain tends to come in waves, gradually increasing to its maximum intensity, then disappearing within 20 to 60 minutes. The pain radiates to the lower abdomen, to the groin and the testicles or vulva.What causes kidney stones
Other symptoms include nausea and vomiting, restlessness, sweating, and blood, a stone, or a stone fragment in the urine. The person may feel the urge to urinate frequently, especially when the stone travels down the ureter. Chills, fever, burning or pain when urinating, cloudy and smelly urine, as well as abdominal swelling at times.
Doctors often suspect stones in people with renal colic. Sometimes the doctor’s suspicion is based on a painful response to palpation in the back and groin or pain in the genital area with no other apparent cause.
Sometimes the symptoms and physical examination findings are so specific that no further testing is needed, particularly in people who have previously had urinary tract stones. However, most people experience severe pain and have symptoms and findings that make other explanations for the pain likely, so further testing is necessary to exclude these other causes.
Peritonitis, which can be caused by appendicitis , ectopic pregnancy, or pelvic inflammatory disease Acute gallbladder disorder ( acute cholecystitis )
Dissecting aortic aneurysm
What causes kidney stones The computed tomography (CT) coil (also called spiral) made without radiopaque contrast material usually be the best diagnostic procedure. CT can locate the stone and also indicate the degree of urinary tract obstruction; it also detects many other abnormalities that can cause stone-like pain.
The main disadvantage of CT is that people who have it are exposed to radiation. Despite this, this risk seems prudent when possible causes include other serious diseases that could be diagnosed with CT, such as an aortic aneurysm or appendicitis.. Newer CT methods and devices are now in common use that limit radiation exposure.
The ultrasound is an alternative to CT and does not require exposure to radiation. However, ultrasound, compared to CT, usually does not identify
The exact location of the obstruction in the urinary tract, nor some of the other serious disorders that can cause the symptoms.
The abdominal X – ray exposes a person to much less radiation than CT, but they are much less accurate in diagnosing stones and can only show calcium stones. When doctors suspect that the person has a calcium stone, the X-ray is an alternative to confirm its presence or to see how far the stone has gone down the ureter.
The IVP (formerly called intravenous urography or IVP) consists of a series of x – rays taken after intravenous injection of a radiopaque dye. This test can detect stones and accurately determine the degree to which they are blocking the urinary tract, but it takes a long time and carries the risk of exposure to the contrast medium (for example, an allergic reaction or worsening kidney failure ).
Clinicians rarely use excretory urography if CT or ultrasound is available.
A urinalysis is usually done , which can show blood and pus in the urine, whether or not symptoms have occurred.
Determination of the type of calculation
When establishing the diagnosis of stones, doctors prescribe the performance of the necessary tests to determine the type of stone. It is convenient for affected people to recover the stones they pass. They can recover them by filtering the urine through a paper or a sieve.
The calculations found must be analyzed. Depending on the type of stone, urine and blood tests will be needed to measure the levels of calcium, uric acid, hormones, and other substances that may increase the risk of stone formation.
In a person who has removed a calcium stone for the first time, the probability of forming another is approximately 15% within 1 year, 40% within 5 years, and 80% within 10 years. The measures necessary to prevent the formation of new stones vary according to the composition of the existing ones.
It is advisable to drink large amounts of fluids (8 to 10 glasses of 300 mL a day) to prevent all types of stones. Other preventive measures depend in part on the type of stone.
People with calcium stones have a disorder called hypercalciuria, in which excess calcium is excreted in the urine. For these people, taking steps that reduce the amount of calcium in the urine can help prevent new stones from forming; One of these measures is to eat a diet low in sodium and high in potassium.
Calcium intake should be close to normal (1000 to 1500 mg daily, about 2 or 3 servings of dairy products a day). The risk of a new stone formation is actually higher if the diet contains too little calcium, so no attempt should be made to eliminate calcium from the diet. However, those affected should avoid sources of excess calcium, such as antacids that contain calcium.
Thiazide diuretics such as chlorination or demimondaine also reduce the calcium concentration in the urine of affected people. Taking potassium citrate helps correct the low level of citrate in the urine, a substance that inhibits the formation of calcium stones. Restricting animal protein in the diet can help reduce urine calcium and the risk of stone formation in many people with calcium stones.
The high concentration of oxalate in the urine, which contributes to the formation of calcium stones, can be a consequence of excessive consumption of foods rich in this substance (such as rhubarb, spinach, cocoa, nuts, pepper and tea) or the existence of certain intestinal disorders (including some weight loss surgery). Calcium citrate, cholestyramine and a diet low in foods with fat and oxalate contribute to reduce the levels of oxalate present in the urine of some of those affected. Pridoxin (vitamin B6) reduces the amount of oxalate produced by the body.
In very rare cases, when calcium stones are due to hyperparathyroidism , sarcoidosis , vitamin D poisoning , renal tubular acidosis , or cancer, the underlying disease must be treated.
Uric acid stones
Uric acid stones are almost always caused by excessive levels of acidity in the urine. To alkalize the urine, potassium citrate should be administered to all people with uric acid stones, as this neutralizes the high levels of acidity that lead to the formation of these types of stones. Sometimes allopurinol or a low protein animal-based diet can be used to lower uric acid levels in the urine.
For stones formed by cystine, urinary cystine levels must be kept low by drinking plenty of fluids and sometimes by administration of alpha-mercaptopropionylglycine (thiopronine) or penicillamine.
People with recurrent struvite stones need to take antibiotics continuously to prevent urinary tract infections .
Non-steroidal anti-inflammatory drugs or opiates are used as needed to relieve pain.
Sometimes removing stones
Small stones that do not cause symptoms, blockage of the urinary tract, or infection usually do not need treatment and usually clear on their own. Larger stones (larger than 5 mm) and those closer to the kidneys are less likely to pass on their own.