Kidney and urinary tract stones form when mineral or acid salts in the urine crystallize. The majority of the stones and crystals formed leave the body with the urine during urination. However, in large stones or in some cases that prevent falling, the stone may need to be broken or surgically removed. Every year, 1 or 2 out of 1000 people experience stone-related kidney pain, that is, acute renal colic. It is 3-5 times more common in men than in women. Diet, obesity, some medical conditions, and some supplements and medications are among the causes of kidney stones. Stones can settle in any part of the urinary tract, from the kidneys to the bladder. Usually, stones form when urine becomes too concentrated, causing minerals to crystallize and stick together. Passing kidney stones can be quite painful, and if detected in time, they usually do not cause permanent damage to the kidneys. Depending on the situation, painkillers and drinking plenty of water are necessary to pass kidney stones. In some other cases - for example, if stones become lodged in the urinary tract, are accompanied by a urinary infection, or cause complications - surgical intervention may be required. If the risk of stones recurring is high, preventive treatment may be recommended to reduce the risk of recurrent kidney stones.
What causes kidney stones?
There is usually no definitive and single cause of kidney stones; many factors contribute to stone stones. It may increase the risk of stone formation. Anyone, whether male or female, can form stones at any time in life. Stones can form if there is an imbalance in the way the kidneys produce urine. This may be related to the amount of water-liquid consumed and the presence or absence of substances that trigger stone formation in the urine. Kidney stones occur when crystal-forming substances such as calcium, oxalate and uric acid in the urine are in greater concentration than the fluid in the urine can dilute, and crystallization and stone formation begin. At the same time, substances that prevent crystals from sticking together (inhibitors such as citrate) may be deficient in the urine, which creates an ideal environment for the formation of kidney stones. Knowing the type, structure and type of kidney stone helps you determine the factors that cause the stone. It may help and give you tips on how to reduce your risk of getting more kidney stones. Therefore, chemical analysis of your kidney stone is very important.
Risk Factors for Stone Formation
1- Family or personal history (Hereditary factors):If one family member has kidney stones, the probability of developing stones in another individual is many times higher than in normal people. If you already have one or more kidney stones, the chance of another stone forming or recurring is very high. The main factor in stone formation is familial and hereditary risks.
2-Dehydration-Thirst:. Not drinking enough water every day is a factor that increases the risk of kidney stones. People who live in hot, dry climates and those who sweat a lot may be at higher risk than other people. Geographically, it is more endemic in people living in hot regions and in Mediterranean countries.
3-Diet-Nutrition: Eating a diet rich in protein, sodium (salt) and sugar, some kidney diseases. It may increase the risk of stone types. This is especially true on a high-salt diet. Too much salt in the diet increases the amount of calcium that the kidneys need to filter and significantly increases the risk of kidney stones.
4-Obesity: High body mass index (BMI), large waist size and weight gain have been associated with an increased risk of kidney stones.
5- Digestive system diseases and intestinal surgery: Gastric bypass surgery, inflammatory bowel disease or chronic diarrhea, calcium and It may increase the amount of stone-forming substances in the urine by causing changes that affect water absorption.
6-Metabolic and hormonal factors: Other medical conditions such as renal tubular acidosis, cystinuria, hyperparathyroidism and recurrent urinary tract infections. It can also increase the risk of kidney stones.
7-Drugs: Excessive vitamin C, food supplements, laxatives (when used excessively), calcium-based antacids and some drugs used to treat migraine or depression can cause kidney stones. It may increase the risk.
Types of Kidney Stones
1-Calcium stones: The vast majority (2/3) of kidney stones are calcium stones, usually in the form of calcium oxalate. Oxalate is a substance made daily by your liver or absorbed from your diet. Nuts and chocolate, as well as nuts and vegetables, also have high oxalate content. High doses of vitamin D in the diet, intestinal bypass surgery, and various metabolic disorders can increase the concentration of calcium or oxalate in the urine. Calcium stones can also occur in the form of calcium phosphate. This type of stone is more common in metabolic conditions such as renal tubular acidosis. Calcium phosphate stones may also be associated with some drugs such as Topiramate, which is used in the treatment of migraine.
2-Struvite stones: Struvite stones form in response to a urinary tract infection. These stones can grow quickly and reach quite large volumes and may not cause much symptoms or signs.
3-Uric acid stones: Uric acid stones are very common due to chronic diarrhea or malabsorption. It can occur in people who lose a lot of fluid, those who eat a high-protein diet, and those who have diabetes or metabolic syndrome. Some genetic and metabolic factors can also increase your risk of uric acid stones.
4-Cystine stones: These stones are formed when the kidneys produce too much of a certain amino acid (Cystine and other dibasic amino acids) in the urine. It occurs in people with a hereditary disorder called cystinuria that causes heartburn.
Symptoms and Symptoms (Renal Colic)
Depending on the characteristics of the kidney and ureter stone, such as its size, shape, and location in the urinary tract, medical symptoms may vary from severe pain (RENAL COLIC) to painless. Kidney stones are usually mobile or kidney stones. It does not cause complaints until it passes into the pipes connecting the ureters - and the bladder. If it gets stuck in the ureters, it can block the flow of urine and cause the kidney to swell and the ureter to contract, which can cause severe pain (renal colic). This is a sharp pain felt in the lower back and flank area (both sides, the area extending from the bottom of the ribs to the hip). If the stone is not in the kidney In the ureter, pain is felt in the groin and thigh area. Men may also experience pain in the ovaries. Renal colic develops as a result of a sudden increase in pressure in the urinary tract and ureter wall. The pain comes in waves and does not decrease unless you change your body position. It is defined as one of the most painful situations you can experience and is likened to birth pain.
These complaints
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Severe, sharp pain in the side and back under the ribs
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Pain radiating to the lower abdomen and groin
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Pain that comes in waves and fluctuates in intensity
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Pain or burning sensation when urinating
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Pink, red or brown urine
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Cloudy or foul-smelling urine
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Continuous urination, urinating more often than usual, or urinating small amounts of urine need
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Nausea and vomiting
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Fever and chills if there is infection
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The pain caused by a kidney stone may change as the stone moves in the urinary tract - for example, moving to a different location or increasing in density.
If you encounter the following, it is useful to seek immediate medical attention:
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Pain so severe that you cannot sit still or find a comfortable position
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Nausea and Pain accompanied by vomiting
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Pain accompanied by fever and chills
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Blood in the urine
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Difficulty urinating
Diagnosis
1-Blood test: Blood calcium and uric acid levels may be high. Again, blood test results can give insight about kidneys and other medical conditions.
2-Urinate: A 24-hour urine collection test shows whether you are releasing too much stone-forming minerals or too little stone-preventing substances. can show. For this test, your doctor may ask you to collect two urine samples on two consecutive days.
3-Imaging Y� Methods:Imaging tests can show stones in the kidney and urinary tract. Stone protocol computed tomography (CT) can reveal even the smallest stones.
4- Analysis of stones: It may be desirable to pass the urine through a strainer to catch the passed stones. Chemical analysis of the stone is important to determine what caused the stone and to prevent the recurrence of the stone. If you are at high risk of stone formation, you will need to undergo additional testing known as a metabolic evaluation.
TREATMENT
Not all stones require treatment. If the stone causes discomfort and does not pass through the urine naturally, treatment may be needed. If the patient has pre-existing medical conditions, different treatment recommendations may be made. If there is a kidney or ureteral stone that does not cause any discomfort, treatment is generally not required. It is necessary to schedule regular checks to evaluate the condition of the kidney and stone and to ensure that it does not get worse. If the stone is likely to be excreted in the urine, medications may be prescribed to facilitate this period. This is called conservative treatment.
If the stone is large and continues to grow, if it causes frequent and severe pain and interferes with kidney functions, if it causes infection and bleeding, intervention may be required for the stone, that is, active treatment is required.
Factors affecting the choice of treatment:
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Your symptoms and complaints
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Characteristics of the stone (location, size, type, cause of stone formation)
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Your medical history
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The treatment method applied in your hospital and your doctor's experience
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Your own personal preferences and values
A-Medical-Conservative stone treatment
The majority of small kidney and ureteral stones pass spontaneously with urine during urination. However, depending on the location and size of the stone, it may take some time to be thrown. If the stone is very small (less than 0.5 cm), there is a 95% chance that it will pass spontaneously within 6 weeks. For this, increase your daily fluid intake (2-4 Liters) and go to bed.
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