Stones in the kidneys what to do. Stones in the kidneys - what can cause these formations? Diagnosis of nephrolithiasis

Normal processes in the urine excretory system a person allows you to excrete small crystals in the urine that form at the level of the kidney. Any deviations in the filtration system of the pyelocaliceal area lead to an increase in these compounds in size. As a result of such processes, stones are formed in the kidneys. This is an intermediate stage of various pathological processes. Violations of the balance of fluids in the body, various infectious and inflammatory diseases lead to their formation, and enlargement leads to.

Neoplasms are small, medium and large.

The study of the pathogenesis of the disease leads to the understanding that the occurrence of stones in the kidneys is such a long pathological condition when impaired functions of the urinary system slowly lead to nephrolithiasis.

Urine is a chemical cocktail, the composition of which is in equilibrium. The organic part is represented by protein compounds, which are decomposition products due to functional activity kidneys in metabolism. The mineral component is phosphates, chlorides, sulfates - dissolved salts.

Chemical processes allow compounds to react with each other. Substances are produced that precipitate out in solid form. Filtration systems do an excellent job of removing such compounds. But, if there is various pathologies, changing the qualitative composition of urine, provoking the ingress of various purulent and blood inclusions into it, the following changes occur:

• The number of protein filaments is reduced. This leads to an increase in the size of primary stones in the kidney.
• Due to the presence of various inclusions (pus, blood), small particles in the urine stick together.
• Are being formed.

Thus, a foundation is created, the basis of which is chemical compounds, protein threads, cheesy formations, microorganisms. Neoplasms accumulate in the collecting ducts, and the process itself originates in the renal pyramids.

The chemical state of microliths is such that various substances, both organic and inorganic, are attracted to them. Over time, stones of different sizes are deposited on the renal papillae, gradually moving to the bladder.

Reasons for the formation of stones

The formation of stones is based on cause-and-effect relationships. First of all causative factor counts age category sick. Age changes affect many systems of the body, which leads to changes in tone muscle tissue, slowdowns in metabolism.

The main reasons for the formation of stones:

• Systemic infectious and inflammatory processes in the human body. The location of the focus does not matter, although renal imbalance and diseases of the urinary system are much more likely to lead to the onset of the formation of microliths due to purulent and blood inclusions in the urine. Kidney stone pathology is a consequence of cystitis, pyelo- and glomerulonephritis.
• Hereditary and non-hereditary metabolic disorders. Crashes in hormonal regulation organisms lead to an increase in mineral salts in urine. The main pathologies are: gout, osteoporosis, hyperthyroidism.
• Diseases gastrointestinal tract lead to changes in the chemical composition of urine. The main pathologies chronic gastritis, ulcers and pancreatitis.
• The consequences of taking medications in the treatment of any disease. Drug therapy leaves an imprint on renal function, which leads to a change in the composition of urine.

Plays an important role drinking regimen patient and water quality. Hard water is different high content mineral salts. Dietary monotony also negatively affects the functions of the urinary system.

Typology of stones

The sizes, shapes and chemical components of stones are varied. calculus right kidney or a calculus of the left kidney - there is no difference. Only its qualitative component is important, which is based on the substance prevailing in the structure. The most common types:

• Cholesterol. The formations are black, unstable.
• Phosphate. These are smooth formations of a grayish-silver color. The structure is not solid.
• Oxalate. The structure of the stones is heterogeneous, the color is gray. Considered durable.
• Urate. Solid formations of yellow and red colors.
• Carbonate. Formations gray shade with a flat surface.
• Cystine. Non-solid structure, light yellow color.
• Protein. Inhomogeneous white non-solid structure.

Small concretions can connect with each other. The overwhelming base will give the neoplasm chemical and physical properties.

Symptoms

Disease for a long time may be asymptomatic. It depends on the nature and size of the stone. Most often clinical manifestations start with a long pulling pains in the lumbar region. Loads, weight lifting, sports cause exacerbation of pain. Pain is not always localized in a specific area. Due to the development of innervation internal organs pain can also be projected into the groin area.

At the first stages, the position of the stones is stable. Severe spasms mean that the location of the stones in the kidney has begun to change, so symptomatic picture changes dramatically when the movement of stones to the bladder begins. In this case, injury to the mucous membranes of narrow vessels occurs. In some cases, ruptures occur, which is manifested by the inclusion of blood in the urine.

The presence of blood clots with a simultaneous change in the color of urine indicates an inflammatory process at the site of the rupture.

Thus, the main symptomatic manifestations kidney stones are as follows:

• Decreased diuresis.
• Urination is accompanied by severe cutting pains.
• Puffiness. Localization is progressing.

The movement of the calculus in some cases clogs the lumen of the urinary tract, which leads to renal colic. This is a syndrome that is characterized by certain symptoms:

• Acute pain syndrome in the lower back.
• Violent spasmodic pain during diuresis.
• Digestive disorders. Vomiting, heartburn, loose stools.

– acute condition in which patients are often hospitalized. Buying it at home is difficult.

Associated kidney infections caused by a violation of the integrity of the urinary tract give symptoms of systemic diseases:

• Temperature.
• Enuresis.
• Chills.

If a complex of symptoms occurs, it is necessary to consult a doctor who will carry out the necessary diagnostic procedures, which will allow you to establish the causes that caused these symptoms and prescribe adequate treatment.

Diagnostic methods

Before treating kidney stones, a diagnosis is made.

The first step after a patient visits a doctor is an examination. This procedure allows you to assess your well-being, palpate the area of ​​pain, determine the boundaries of the location of the organ.

The anamnesis reveals the whole complex of the patient's complaints. The presence of chronic diseases is excluded or confirmed.

After examination and anamnesis, the doctor directs the patient to biochemical research, which include general analysis blood, urinalysis.

The results of a urine test are of particular interest to the doctor, since an increase in certain indicators indicates the presence of stones. Leukocytosis, a large amount of uric acid, and mineral salts are usually detected.

Blood test reveals possible accompanying illnesses, the consequences of which affected the excretory function of the kidneys.

The next stage of diagnostics is instrumental methods.

• Radioactive tomography of the pelvic organs.
• Magnetic nuclear tomography.
• Ultrasound of both kidneys and all urinary system.

It is ultrasound that allows you to confirm the presence of even the smallest formations. The basis of treatment will be based on the localization of the stone, which makes ultrasound a fundamentally important study.

Based on the identified features of the pathology, treatment is based.

Approaches to therapy

Treatment is based on three main principles, the methods of which are based on the size of the stones.

• Treatment based on the dissolution and removal of small stones, whose size varies up to 6 millimeters.
• The method of crushing stones without surgery. This method is suitable for formations of medium size - about 4 mm.
• Removal of stones by surgery. Only large stones are extracted in this way. The operation can be performed in stages if a bilateral lesion is diagnosed. For example, if the size of the right calculus (in the right kidney) is large, and the left stone (in the left kidney) is small, then a large formation is first removed, and after a while a smaller one.

Conservative treatment is carried out with the help of medicines that increase diuresis, as well as using herbal medicine. Main medicinal herbs that apply in such cases are:

• Bearberry.
• Corn stigmas.
• Kidney tea.
• Lingonberry leaf.
• Marena dyeing.

Means that improve functionality kidneys are also based on herbs. Their components dissolve stones in the kidneys.

• Kanefron. Presented in two forms. Tablets and solution. The course of treatment is long.
• Cyston. Ayurvedic remedy containing a large number of herbs. Treatment is long.

In addition to the above therapy, the dietary component for the patient is important.

• If urates are detected, it is recommended increased amount vegetables and fruits.
• Foods containing a large amount of fiber are recommended when oxalates are detected.
• Phosphates are well excreted when carbohydrates and young meat are included in the diet.

If there is an associated infection, then antibiotic therapy is performed. Antimicrobials are selected individually and only by a doctor. More often than others, a group of cephalosporins is prescribed, since their excretion is carried out through the kidneys.

The duration of therapy for kidney stones means that this is a pathology that needs to be given great attention.

Conclusion

Kidney stones are a common pathology, the varieties of which determine the diagnostic and therapeutic procedures. It is better for people who feel the first symptoms of this disease to immediately consult a doctor in order to avoid complications and a long period of rehabilitation.

Currently, a large number of people are diagnosed with kidney stones in a large number of people.

Pathology can manifest itself at any age, and its therapy is considered a complex and lengthy process.

Kidney stones - what is it? To apply in a timely manner medical care, you need to know the types of stones and options for getting rid of them.

How stones are formed

Pathological processes in the urinary system can manifest themselves against the background of problems with colloidal balance and deformation of the renal parenchyma.

Stones are formed from fibrin filaments, amorphous urine sediment, foreign inclusions, cellular detritus, various kinds bacteria and salts.

The process of stone formation itself takes a long time.

Initially, sand and microliths, miniature pebbles, are collected in certain places.

Almost always a person does not even suspect that he is developing pathological process, because all these formations come out when urinating on their own.

They are delayed in the case when a person already has various diseases, he does not eat properly, has poor heredity or an abnormal structure of organs. Such processes cause the layering of various substances on the microlite, forming a calculus.

Types of kidney stones

Stones in the kidneys can differ in several ways: shape, quantity, size and chemical composition.

It is necessary to consider in more detail the types of stones according to the most important criterion - chemical composition:

1. Phosphates are stones that are based on the calcium salt of phosphoric acid. They can form with pyelonephritis and look like white or light and smooth stones.
2. Oxolates are stones that arise from salts of oxalic acids in alkaline or acidic environment. They are often dark in color and shaped like spikes with a pointed edge.
3. Cystines are stones found in those patients who have problems with the absorption of cystine and diaminomonocarboxylic acid. In appearance, they are light white and smooth, have a soft structure and rounded shapes.
4. Urates are stones that occur in an acidic environment from the salt of uric acids. They are quite hard, have a brick hue and a smooth texture.
5. Carbonates are stones that are formed under the influence of the calcium salt of carbonic acid. Their shape can be varied, the color is light, and the structure is soft and smooth.
6. Cholesterol - formations of a fragile nature, black. These stones are very rare.
7. Protein - stones that are caused by an increase in fibrin and negative impact bacteria on genitourinary system. They are always small and soft, have a light color.

In addition, there are several types of stones:

1. Radiopaque - visible on x-rays.
2. Stones with poor radiopacity are practically invisible on x-rays.
3. X-ray negative - stones that cannot be detected using x-rays.

To identify which stone was formed in a particular patient can only qualified specialist after the complete examination body of a sick person.

Why kidney stones form

The pathology under consideration can occur for several reasons. They are:

1. Having poor genetics when next of kin have been diagnosed with kidney stones.
2. Launched infections urinary organs that violate the filtration and excretory function of the kidneys.
3. Lack of vitamins A and D in the body.
4. Regular use of hard water.
5. Pathologies that provoke a violation of the water-salt balance.
6. Incorrect passage of urine, which is caused by adhesions, inflammatory processes, the presence of scars or tumors.
7. Severe dehydration, low fluid intake, living in dry and hot climates.
8. Treatment with non-steroidal anti-inflammatory drugs, antibiotics and glucocorticoids.
9. Consuming a lot of protein.

Today, scientists have not fully understood exact reasons the formation of stones in the kidneys.

There are several versions here, but the most common is the hypothesis of the fusion of salt crystals, which is facilitated by a hydrophobic colloid. This component is a mucoprotein - mucus, pus or sulfur.

Special attention should be given to what a person takes in food. The composition of the consumed products depends on the soil in which they grew.

Very often, calculi are formed with frequent consumption of meat, offal, spinach and peas.

Symptoms of pathology

If a urolithiasis is not complicated, then it may not give out any signs.

In rare exceptions, patients experience blunt painful sensations in the waist.

Intense symptoms begin when the stone moves, causing renal colic. Her symptoms are:

1. Sharp pain in the lumbar region on the affected side.
2. Temperature jump.
3. Nausea and vomiting.
4. Refusal to eat.
5. Dry mouth.
6. Presence in urine blood impurities, epithelium and leukocytes.
7. Increased heart rate, irregular heartbeat.
8. Pain in the back of the chest.

If the stone reaches the urinary tract and blocks them, then the person often has oliguria or anuria. When the calculus is excreted in the urine, the symptoms disappear on their own.

With the development of pyelonephritis, the patient is concerned about the following:

1. Severe back pain.
2. Rise in temperature to high levels.
3. Poor health, increased weakness.
4. Nausea, which may be combined with vomiting.
5. Loss of appetite.
6. Rapid fatigue.
7. Changes in the consistency, quantity and color of urine.

If a person has similar symptoms, then you can not hesitate to visit the doctor. Only an experienced physician can diagnose the disease in a timely manner and prescribe adequate therapy, thanks to which the patient will avoid dangerous complications.

It should be noted that some people have been living with kidney stones for decades and are not even aware of their presence.

How to diagnose kidney disease

A preliminary diagnosis can be made by history - patients often visit a doctor already during renal colic, which causes discomfort or pain in the lower back.

Acute pain in the right side may indicate the development of appendicitis or cholecystitis.

Therefore, the doctor should carefully study the duration of the symptoms, inquire about the presence of pain during the exit of urine and conduct an examination of the patient's body.

Research in the laboratory

Laboratory examination consists of several tests. They are:

1. Urinalysis, which shows red blood cells, white blood cells and bacteria.
2. Biochemistry of urine helps to determine the amount of amino acids and salts in urine.
3. Taking urine samples.
4. A general blood test, which makes it possible to detect inflammatory processes in the body.
5. Blood biochemistry helps to identify metabolic problems.

Such tests should be carried out if any kidney pathology is suspected.

Instrumental examination

With the help of certain procedures, you can get a more accurate idea of ​​\u200b\u200bthe pathology.

These procedures should be studied in more detail:

1. Fluoroscopy or survey urography held in lying position and with breath holding. The method is based on the demonstration of the shadow of the kidneys, urinary or foreign body, which exceeds 4 millimeters in diameter. If such shadows are present, then this indicates a stone, cyst or neoplasm. It is noteworthy that sometimes it is impossible to recognize a single calculus. Do not eat before the x-ray. And it is worth considering that the procedure is harmful to health, because the body is irradiated with an X-ray beam.
2. Ultrasound - diagnostics, with the help of which it is possible to clarify the size and location of the kidneys, their shape and the presence of stones in them. The procedure should be carried out before meals and with full bladder. This suggests that the patient should drink at least 800 milliliters of water. Ultrasound procedure involves the use of a gel that is applied to the skin in the right place. This gel promotes the penetration of sound waves into the organ and the display of its image on a special monitor. Such a diagnosis is not harmful to humans.
3. Magnetic - resonance imaging considered the most effective methodology examination of diseased kidneys. You don’t need to specially prepare for it, the only caveat is that you will have to remove all jewelry and watches on your body.

An MRI requires a magnetic tunnel that photographs the kidneys from all angles.

Although the device emits a radio frequency pulse and a magnetic field, doctors do not use ionizing radiation, so the procedure is harmless.

Currently, more and more specialists use x-rays and ultrasound, because such studies are available and informative.

Most often, such a diagnosis is sufficient to make a diagnosis and study the nature of the stones. But to detect small stones, more accurate equipment is required.

How to treat kidney disease

In order to get rid of small stones, you should drink more water and follow a certain diet, which your doctor should tell you about. A menu is compiled taking into account the composition and size of stones.

Stones smaller than 5 millimeters almost always pass on their own after proper treatment.

Education with a diameter of up to 10 millimeters independently leaves the kidneys in 50% of cases. Well, the calculus, the size of which exceeds 10 millimeters, has to be removed with special therapy.

Main task medical measures is to rid the patient of kidney stones.

The treatment regimen should be based on the results of the tests, the size of the calculus and its location. The following groups of drugs are most often used:

1. Antispasmodics: No-shpa, Papaverine.
2. Substances that can dissolve stones: Urolesan, Cyston.
3. Antibiotics a wide range Actions: Augmentin, Ceftriaxone.
4. Diuretics: Furosemide.
5. Alpha-blockers, provoking the release of a calculus located at the bottom of the ureter.

In addition, you should follow the drinking regimen and the conditions of a strict diet.

Performing a surgical intervention

There are situations when conservative treatment not enough to get rid of the problem.

If present in the kidneys big stones doctors prescribe surgery.

There are several options for operations. They are:

1. Shock wave lithotripsy is a procedure for crushing a calculus using ultrasound. If the pathology is not complicated and the stone does not exceed 1.5 centimeters in diameter, then it is customary to perform it in outpatient settings. To do this, you need to place a special device on the place where the stone is located, make a small incision and insert a crushing nephroscope into it.
2. Laser lithotripsy - the use of a special laser that passes through the urethral canal and turns stones into dust.
3. Percutaneous nephrolithotomy is a technique used when the stones are quite large and cannot be crushed by a laser.
4. Ureteroscopy, which is commonly used when removing a stone from the ureters.

When the mass is removed from the kidney, it must be carefully examined to determine its type.

Based on the results of this study, it is possible to prescribe prophylaxis, which will help eliminate the risk of developing the same stones in the future.

If therapy is carried out untimely or incorrectly, then the patient may develop such dangerous complication like pyelonephritis - inflammation of the kidneys.

Such a disease, in turn, causes paranephritis - the appearance of abscesses. If these processes are not eliminated, then renal failure, nephrosclerosis and death are possible.

Prevention of nephrolithiasis

It is worth considering that even surgical intervention does not guarantee the absence of recurrence of the pathology in question.

In order to prevent the re-emergence of calculi, it is worth following a few simple rules:

1. Drink only water purified from various inclusions.
2. Eat a varied diet rich in vitamins and minerals.
3. Do not abuse alcoholic beverages.
4. Quit smoking.
5. Do not run existing infectious diseases. They should not be allowed to enter the chronic stage.
6. Prevent severe dehydration.
7. Eat less salt.
8. Exercise and move more.
9. commit hiking by fresh air.
10. Do not overcool the body, always dress for the weather.
11. Avoid the appearance of pyelonephritis or cystitis.

Secondary prevention is based on the timely detection of the problem and the beginning of its treatment.

Kidney stones are an unpleasant and dangerous pathology. At present it is surgical removal stone is considered the most reliable treatment option, because medical preparations are not always up to the task.

Useful video

Kidney stones are a pathological condition that develops as a result of a violation of the properties of urine. The disease that develops in this case is called urolithiasis. It can develop in both children and adults. Men get sick more often, in most cases they have a calculus of the right kidney.

What causes stone formation

The following reasons underlie the formation of microliths in the kidneys:

1. Violation of the outflow of urine. block the ureter or bladder can tumors, adhesions, inflammatory narrowing of the urinary tract. The flow of urine will also be disturbed when the kidney is lowered, and with some anomalies in the development of the urinary tract.
2. Changes in the colloidal properties of urine, which can be both congenital and acquired.
3. Violation electrolyte metabolism due to one of these conditions: gout, dysfunction parathyroid glands, destruction bone tissue with osteomyelitis, osteoporosis. Other pathologies in which the level of calcium in the urine increases.
4. Taking certain medications regularly These include: Aspirin, Tetracycline, Biseptol, Almagel, Sulfasalazine, glucocorticoids (Hydrocortisone, Dexamethasone, Prednisolone and others).
5. Dehydration due to: severe physical work, hot climate, an illness that occurs with one of such symptoms as shortness of breath, diarrhea, fever, vomiting.
6. Lack of vitamins A or D.
7. The predominance of meat products in the diet.
8. Drinking hard water.
9. Infections of the urinary system (therefore, you need to know how to treat the kidneys before their disease develops).

The mechanism of stone formation

The Lichtwitz-Schade theory is considered the most successful hypothesis explaining the mechanism of stone formation. These scientists say the following: urine is a supersaturated solution of various substances. There are more crystals in it than anywhere else, but they are in normal conditions do not precipitate. This is facilitated by the protein compounds located here. They, surrounding the crystalloid molecules with negative charges, do not allow them to "stick together" and precipitate. This is the so-called protective colloid.

is the process of stone formation leading to pathological changes organs of the urinary system. This disease has several names: nephrolithiasis or nephrolithiasis.

Any cell of the body produces metabolic products that are removed from the body through the excretory system, one of the main organs of which are the kidneys. They begin to form from 3 weeks of intrauterine life. First, a pronephros is formed as a system of small tubules at the head end of the embryo, which does not perform an excretory function. Then they are reduced, and in its place a primary kidney is formed - a similar system of tubules, but already interacting with circulatory system. This is how the release of metabolic products into the common duct begins.

In the second half of pregnancy in place primary kidney comes secondary, it is located at the pelvic end of the embryo. water release, toxic substances and metabolic products occurs in the amniotic fluid, and then excreted through the mother's kidneys. After the birth of a child, the excretory organs begin to work independently. As they grow older, they increase in size, the final development ends at 7-10 years.

Suitable for every kidney renal artery through which blood enters for filtration through the nephron system. After that, it exits through the vein of the same name, and the products of exchange with the liquid enter the ureter, from where it enters the bladder and to urinary tract. Every day about 100-200 liters of primary urine is filtered, some of which is reabsorbed, and only 3-10 liters are excreted.

Epidemiology

Kidney stone disease is common and usually epidemic in the countries of Asia Minor, the Scandinavian Peninsula, Northern Australia. In Russia, most cases are observed in the Nenets autonomous region, Karachay-Cherkess Republic, Altai Territory.

According to the chemical composition, there are 3 main types of stones:

1. Oxalates - in 56% of cases - calcium salts of oxalic acid.
2. Urate - 19% - crystals of uric acid and its salts.
3. Phosphates - 8% - calcium salts of phosphoric acid.

Reasons for the formation of kidney stones

1. Climatic - abrupt change climate, as a result of which the body does not have time to rebuild the water balance.
2. non-compliance water balance.
3. Food - the absence or, conversely, an excess of any products.
4. Genetic - hereditary predisposition.
5. Lifestyle - profession, use of drugs, ecological environment, bad habits.
6. Renal - pathologies of the tubules and glomeruli, such as nephritis, tubulopathy, Fanconi syndrome, impaired urine outflow.
7. Endocrinological pathologies - metabolic disorders, diseases of the thyroid and parathyroid glands.
8. Infectious - the composition of urine changes during the life of microorganisms.

Signs of the presence of stones

The second sign is cloudy urine, the presence of impurities in it. In addition, a patient with calculi has an increased body temperature, nausea, and painful urination.

The calculus of the left kidney appears weakly, in the form feeling unwell, fatigue, pain behind the sternum. The calculus of the right kidney is similar in symptoms to appendicitis, because it is characterized by intense pain in the lower back, radiating to the legs and groin. Calculi of both kidneys are less common and more difficult to treat.

Diagnosis of nephrolithiasis

The predicted diagnosis is based on the data of the anamnesis - the patient most often presents with a problem renal colic, which manifests itself in the form of tingling in the lumbar region. At acute pain on the right side, appendicitis or cholecystitis must be ruled out. The doctor collects information about the duration of the disease, pain during urination and the presence of sand or stones in the urine.

Then you need to pass a general analysis of blood and urine, great content in them salts, proteins, leukocytes speaks of deviations in the work of the kidneys, the inflammatory process in the body. Biochemical analysis will allow you to determine the nature of the stones and their reaction to various medications.

More accurate data can be obtained from instrumental research- X-ray, ultrasound, MRI. After receiving all the results, the doctor prescribes an individual course of treatment.

X-ray - survey urography

The last meal before the X-ray should take place at 18:00. This diagnostic method is harmful to health, as it is used X-rays Therefore, it should be carried out no more than once every six months.

ultrasound

MRI of the kidneys

MRI is performed using a special device - a magnetic tunnel, which allows you to take pictures of the kidneys in all planes. AT this method high RF pulses are applied and magnetic fields. Due to the absence of ionizing radiation, the study is absolutely safe.

Treatment of nephrolithiasis

The dissolution of calculi is used only for urates; for this, medications, such as Phytolysin, based on the fact that urine becomes alkaline.

Lithotripsy- method of crushing kidney stones using ultrasound. A special ultrasound device focuses on the location of stones in the kidneys and a nephroscope is inserted through a small incision, which crushes the stone. Laser lithotripsy is performed using a Holmium laser, which, using an endoscope, reaches the calculus through the urethral canal and destroys it, turning it into dust.

With timely and proper treatment outcomes are favorable, the likelihood of recurrence is small with further adherence to recommendations consisting in lifestyle changes. But it should be understood that getting rid of the calculus does not mean getting rid of the disease.

Effects

Prevention

The most important thing is proper nutrition. It consists in the rational use of food, the avoidance of overeating, the absence of alcohol and other poisons in life. The amount of salt in the diet should be no more than 10 grams per day. You should try to consume more fiber, avoid processed foods, trans fats and fast carbohydrates.