Life 53 _ Kidney stones
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KIDNEY STONES

Kidney stones (also known as urolithiasis – from the Greek lithos, stone) are hard deposits made up of minerals and salts that form inside the kidney or ureter, the tube that connects the kidneys to the bladder.
Kidney stones are a common cause of hospitalization in North America. It is estimated that around 10% of people on the continent have kidney stones at least once in their lifetime and are most prone to them when they are between the ages of 20 and 50.

According to statistics, the rate of men with kidney stones 3 times more than women. In addition, the disease may recur in people who have had kidney stones in the past.

Kidney stones can occur anywhere from the kidneys, through the urinary tract, to the bladder. Normally, stones form when urine concentrates and the concentration of minerals in the kidney increases, then crystallizes and sticks together into small particles, the mass of these particles will increase and solidify over time.

In fact, the size of the stones can be very small and are easily excreted from the body in the urine without causing pain, but can also grow to a few centimeters and cause great pain. When the stone goes down into the ureter, the bladder, and therefore it is easy to damage the urinary tract. In the case of trapped kidney stones, they cause an obstruction, directly affecting the kidney nerves and causing pain to the patient. In many cases, the obstruction of the urinary tract causes a buildup of urine, causing inflammation. Kidney stones are one of the causes of kidney failure.

However, even though kidney stones can be quite painful, they usually don’t cause permanent damage if found in time. Depending on the patient’s condition, it may be enough to take pain relievers and drink plenty of water to clear kidney stones. Only in exceptional cases – for example, if the stone gets stuck in the urinary tract, is associated with a urinary tract infection, or causes complications – that surgery may be necessary.

TYPES OF KIDNEY STONES

Knowing what type of kidney stones you have can help determine its cause, and of course, there may be more ways to lower your risk of getting kidney stones again. So in fact if you urinate a stone and if possible collect some of your stones to give to your doctor for analysis.

Based on the composition of the stone, kidney stones are classified into six common types: calcium stones, oxalates, phosphates, uric acid, struvit, cystine. Each type has different causes of training and treatments.

  1. Calcium stones
    Calcium stones are the most common of all calculations. Calcium stones are very likely to recur and are common in men between the ages of 20 and 30. The main cause is that the state of the urine is too saturated with calcium salts due to increased absorption of calcium in the intestine or increased reabsorption of calcium in the renal tubules, increasing the concentration of calcium in urine, increasing the risk of kidney stones.
  2. Oxalate stones
    This type of gravel represents a high proportion in tropical countries. When the urine is saturated with oxalate, of course there is too much oxalate in the kidneys, which can lead to kidney stones. Oxalates often combine with calcium to form calcium oxalate stones.
  3. Phosphate stones
    The most common type of phosphate rock is the ammonium magnesium phosphate type. This gravel has a large size, coral shape and contrast. Stones form as a result of infections of the urinary system, especially proteus (a genus of bacteria in the Enterobacteriaceae family, commensal to the digestive tract).
  4. Uric acid stones
    Uric acid stones are common in men. Increased uric concentration in the blood, in addition to deposits in cartilaginous organisms, mucous bags, muscle skin … uric concentration in the kidney also increases. Urine deposition in the kidney is the main cause of uric stones, commonly seen in patients with gout (a consequence of disturbances in nucleic acid metabolism).
  5. Struvit stones
    Struvit stones are common in women with urinary tract infections. Struvit stones are caused by long-term urinary tract infections. These stones can grow quickly and become large and easily block the urinary tract. However, it often presents few symptoms or little warning.
  6. Cystine stones
    Cystine stones are relatively rare. The stones formed by cystine are more excreted by the kidneys but less soluble, so they are easily deposited. This stone is usually due to a congenital disorder of the transport of cystine reuptake in the renal tubules and the intestinal mucosa.

SYMPTOMS OF KIDNEY STONES

While stones form in the kidneys as well as throughout the urinary system, they hardly cause any symptoms. It is only when the stones travel through the kidneys or enter the ureter (the tube connecting the kidney to the bladder) that problems begin.

If it gets stuck in the ureter, it can block the flow of urine and cause the kidneys to swell and the ureter to contract painfully. And, at this time, the following signs and symptoms will appear:

  • Severe pain, shooting pain in lower back and back, under ribs, pain extending to lower abdomen and groin, and pain in waves, sometimes much, sometimes less. Kidney cramps occur in waves and progress to seizures of a few minutes each and most often occur in the early morning or late evening, when the patient is resting while lying or sitting.
  • The ureter is the passage of urine from the kidneys to the bladder. When a stone forms here, it causes rubbing or obstruction of the urine leading to pain in the back, the pain can spread to the lower abdomen, ribs and thighs.
  • Pain or burning sensation when urinating, burning or incontinence. When the stone gets stuck in the ureter or bladder, the patient will feel sad to urinate and urinate very often, but the amount of urine is very small. It makes the body tired. Especially when stones are in the ureter and cause obstruction, urine cannot reach the bladder, and kidney stasis causes kidney pain. When the stone passes from the ureter to the bladder or from the bladder to the urethra (the last part before the urine is expelled), pain and even severe pain when urinating.
  • Bloody, pink, red or brown urine, cloudy or smelly urine. Blood in the urine due to the rubbing of a stone when moving to the affected area. This is considered to be a common symptom of kidney stones. However, depending on the lesions that manifest hematuria that can be seen with the naked eye or that must be observed under a microscope to see.
  • Nausea and vomiting. The kidneys and intestines are linked by nerves. Kidney stones can affect the digestive tract and cause nausea and even vomiting.
  • Fever and chills in case of infection. Kidney stone disease is easy to lead to urinary tract infections. Because, when the moving stone causes damage or the stone gets stuck, the urine cannot be expelled. All of these factors increase the risk of upstream infection. In other words, if the flow of urine is blocked, the kidneys can be invaded so quickly that a serious infection called pyelonephritis is more likely to occur.

Make an appointment with your doctor or go to the hospital as soon as possible if:

  • You have severe pain in your lower abdomen, lower back, or testicles in men
  • Abdominal pain with nausea and vomiting
  • Abdominal pain with fever and chills
  • Difficulty passing urine or blood in the urine

CAUSES AND RISK FACTORS OF KIDNEY STONES

Kidney stones often do not have a single, specific cause, although a number of factors can increase the risk of disease.
Diet, excess body weight, certain medical conditions, and certain supplements and medications are among the many causes of kidney stones.

During the operation, instead of releasing dissolved toxins and urine, it settles and turns into stones in the kidneys. With the function of maintaining the body’s water balance while eliminating and excreting harmful substances in the body through the urine, when kidney stones are present, this function is not performed effectively. Depending on the weather, location and sedimentation, the stones have different sizes.

Here are some of the specific causes as well as the specific risks that can cause kidney stones:

  • Family or personal history.
    If someone in your family has had a kidney stone, you are also more likely to have one. In other words, when someone in the family carries the gene, everyone in the household is at increased risk of developing kidney stones. In cystine stones, for example, they form in people with a genetic disorder called cystinuria which causes the kidneys to excrete too much of a particular amino acid. Or, certain genetic factors can also increase the risk of uric acid stones. On the other hand, if you have ever had one or more kidney stones, you are at a higher risk of developing more.
  • The body lacks water
    Not drinking enough water each day can increase your risk of kidney stones. Because not drinking enough water results in urinary concentration, the concentration of saturated crystals in the urine.
    People who live in hot, dry climates and those who sweat a lot tend to urinate less often and may be more susceptible to disease than others.
  • Food is not scientific, uses a lot of oxalate, a certain diet. A diet high in protein, salty, fatty and sugary foods can increase the risk of certain types of kidney stones. This is especially true of diets high in sodium and salty. Too much salt in your diet will increase the amount of calcium your kidneys have to filter and greatly increase the risk of kidney stones.
    In it, the form of calcium oxalate is a substance created daily by the liver during the metabolism of glyco or absorbed by a diet that is too salty or high in oxalate such as foods such as almonds, walnuts, walnuts. cashews, peanuts as well as beans; fruits such as berries, kiwis, purple grapes; Vegetables like okra, leek, spinach, turnip … and chocolate, cocoa, tea, etc. also contain high oxalates.
  • Arbitrary and self-prescribed use of drugs, indiscriminate consumption of drugs not under the direction of a doctor can lead to kidney stones. According to UK experts, long-term abuse of antibiotics will increase the risk of kidney stones. Certain classes of antibiotics are often cited such as: cephalosporin, penicillin
    Long-term use of certain medicines, even if directed by your doctor, can also cause kidney stones. For example, acetazolamide (Diamox), loop diuretics, glucocorticoids, theophyline, vitamins D and C are known to promote calcium stone formation. Thiazides, salicylate, probenecid, and allopurinol diuretics are agents that promote uric acid stone formation. When taking drugs such as triamterine, acyclovir, and indinavir, these drugs get deposited on the stones that have formed and make the stone grow bigger faster.
    In addition, overuse of certain supplements, laxatives, calcium-based antacids and certain drugs used to treat depression or treat migraines or seizures, such as topiramate (Topamax, Trokendi XR, Qudexy XR), etc. may also increase the risk of kidney stones.
  • People suffering from digestive diseases and surgery.
    People who have had surgery or used certain medications have a higher risk of developing kidney stones. Gastric bypass surgery, inflammatory bowel disease, or chronic diarrhea can cause changes in the digestive process that affect the absorption of calcium and water, increasing the amount of stone-forming substances in the urine. of the patient.
  • People with other medical conditions such as prostate enlargement, fibroids, diverticulosis in the bladder, causing urine to accumulate in the interstitial space. People with renal tubular acidosis, cystinuria, hyperparathyroidism or disease rich in parathyroid hormones, recurrent urinary tract infections, ulcerative colitis or Crohn’s disease, disease of the intestinal microflora Bacteriophages, scientifically known as Oxalobacter formigenes, increase absorption of oxalates in the intestine, also contribute to kidney stones; then it is called Dent Disease – an inherited disease that damages the kidneys; diabetes, obesity, etc. followed by bowel surgery and certain metabolic disorders can also increase the levels of calcium or oxalate in the urine.
  • People with birth defects or due to urine can not be released, accumulate over time to form stones.
  • People were lying down for a long time.
  • Obese people. A high body mass index (BMI), large waistline, and weight gain have been linked to an increased risk of kidney stones.
  • People with prolonged insomnia. Damaged kidney tissue is able to regenerate itself when the body falls asleep. Therefore, if the patient suffers from prolonged insomnia, this function will not be performed, the longer it remains, the higher the risk of kidney stones.
  • People who often fast for breakfast. Bile fluid plays an important role in the digestion of food. Especially in the morning, the body needs a lot of energy after a long night’s sleep. However, fasting for breakfast prevents bile fluid from being released to digest food, but from building up in the gallbladder and intestinal tract, causing high cholesterol and calcium, not only the direct cause. gallstones but also kidney stones. In fact, people with gallstones are at a higher risk of developing kidney stones and vice versa because the two diseases share the same mechanism: metabolic disorders.
  • And, who often has the habit of holding urine. Regular urination prevents the elimination of minerals, but leads to deposits. When enough calcium builds up, kidney stones form.

PREVENT KIDNEY STONES

Before we talk about needing to see a doctor or seek treatment in the hospital, here’s what each of us can do to prevent and possibly even make a positive contribution to the safe and effective self-treatment of kidney stones.

Regarding food and drinks

  • Should drink enough water in 1 day. For people with kidney stones or at high risk of kidney stones, drink 2 to 3 liters of water / day.
  • Lemon juice is a good choice because it can help prevent uric acid stones as well as calcium oxalate.
  • Cranberry juice: Kidney stones have been shown to be associated with high levels of calcium in the urine, and cranberry juice has been shown to decrease calcium levels in the urine.
  • On the contrary, carbonated drinks and alcoholic drinks should be avoided. Limit your intake of coffee, cocoa, and tea.
  • Practice bland food, reduce salt. Binge eating can also reduce the risk of kidney stones, as a salty diet often results in loss of calcium through the urinary tract and, of course, through the kidneys. The more calcium and oxalate there is in the kidneys, the greater the risk of kidney stones.
  • Cut down on red meats and replace them with poultry and fish. Avoid processed foods, fried foods, fatty foods, cholesterol, cheeses, etc.
  • For people with kidney stones or at high risk of kidney stones, it is necessary to limit foods rich in oxalic acid like apples, garlic, onions, strawberries and nuts.
  • However, if you still want to eat the foods high in oxalic acid mentioned above, then you must eat with foods high in calcium to avoid the risk of kidney stones. Because during digestion, oxalate and calcium will work together before reaching the kidneys, thus reducing the risk of kidney stones.
  • So, one should eat a variety of foods rich in calcium such as milk, yogurt, cheese or vegetables such as cauliflower, kale, watercress, okra to increase calcium intake in the body. Legumes like kidney beans, green beans, walnuts, or salmon also contain a lot of calcium.
  • Okay, if you eat wheat germ with oatmeal, be sure to add milk. If you eat a kiwi smoothie, be sure to add a little milk to balance it out.
  • After that, it must be said that kidney stones are probably not due to a diet too rich in dairy products because some misconceptions previously avoided dairy products. Although stones are made up of calcium, various scientific studies have shown that a diet rich in calcium actually reduces the risk of stones.
  • In addition, magnesium has also been shown to prevent all types of kidney stones. Eat more foods rich in magnesium. Some of these foods include squash seeds, tofu, wheat germ, seafood, and dark green vegetables like spinach.

About body movements.

  • It is necessary to maintain a regimen of gentle exercises such as yoga, walking, cycling, swimming for good health, eliminating the risk of disease.
  • Maintain a reasonable body mass, avoid overweight and obesity
  • Supplement of vitamins and minerals. If you tend to get kidney stones, include 800 mg of magnesium and 100 mg of vitamin B6 in your daily diet. These two nutrients have been shown to prevent recurrence in people who have had kidney stones in the past.

About Post Author

Maître VIKUDO

Docteur en Physiopathologie
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