Kidney stones: etiology, symptoms e treatment.

Urinary stones can cause sudden colic and require urgent treatment.

Understand how to avoid them or how to best solve this problem.

 

By Dr. Edibert Melchert and Dr. Marcelo Schneider Goulart, urologists

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Stones in the urinary system are a common problem and if you didn't have experienced a renal colic you probably know someone who has already gone through it. About 1 in 5 people have or will have a stone in the urinary system, genetic factors and life habits are implicated in their origin, mainly low water intake, the low consumption of nutritious foods and the sedentary lifestyle.

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What are kidney stones made of?

The stones are small formations whose composition can vary. In most cases they are made of calcium oxalate, a combination of substances that are normally present in the urine, but depending on factors such as amount of water and the pH of the pee may form crystals that bind until they are a true stone. Other stones are made of uric acid, a substance present in many foods and that the ingestion in excess or by a change in metabolism, also forms crystals in the urine. Calculations of uric acid build up quickly and people with this type of stone can suffer from kidney cramps several times in life if there is no proper treatment. There are also stones made of struvite, they are caused by bacteria that infect the urine and, if left untreated, alter the composition of the pee. Just as some bacteria make yogurt from milk, these microbes turn the urine into stones, which can completely fill the kidney, reaching very large sizes and requiring more complex surgeries for its solution.

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Why do urine stones hurt?

When urinary lithiasis forms, it does not cause pain, because inside the kidney there is room for urine to be eliminated. In this way it is common to find stones inside the kidney during routine scans or for another health problem. In these cases, we say that lithiasis is asymptomatic. When a stone reaches a large size inside the kidney or when, even small, it leaves the kidney and passes into the ureter, the narrow channel that carries the kidney pee into the bladder, the urine flow can be stopped. Obstruction of urine output increases pressure within the renal unit, as the kidney is all encased in innervation, distention of the renal capsule promoted by abrupt dilation of the urinary system will strain the nerves causing the intense pain known as renal colic.

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Can urinary lithiasis be prevented?

Yes! Kidney stones has prevention and many patients with this problem do not know this. The medicine already has a lot of knowledge about the process triggering the lithiasis and, although there is no magic solution, as well as diabetes and high blood pressure, avoiding the formation of stones in the urine requires periodic control and eventually professional follow-up. Potential stones can be avoided with healthy lifestyle habits: drinking water frequently, maintaining weight within the normal range and practicing physical activities are sufficient. However, half of those who have experienced one renal colic may have another within five years. These individuals are called lithiasis formers and need follow up with the urologist.

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Whenever possible the calculations should have their composition evaluated and, depending on it, the specific etiology can be diagnosed as metabolic problems, obesity, poor diet, etc. Calcium oxalate calculations, which are the most common, can be avoided by increasing the intake of water, reducing the intake of animal proteins, avoiding snacks, fried foods and soft drinks, decreasing salt levels in food and practicing exercise daily.

In cases where, during follow-up, the patient remains forming kidney stones, medications are available to prevent stones from growing and facilitating their elimination.

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What is the treatment for renal colic?

When a stone is causing renal colic and painful symptoms, or by altering the correct functioning of the kidney, it may be necessary to remove it. In these cases the urologist should be consulted. In addition to pain treatment, examinations to determine the size and location of the lithiasis are requested, ultrasound and tomography of the urinary tract are the indicated exams, the latter being the preferred modality when possible. From the information provided by the tests the urologist can indicate how best to clear the kidney, which is usually by endoscopy.

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How is the surgery for urinary stones?

Currently surgeries for the treatment of urinary lithiasis are done by endoscopy, that is, through cameras that navigate within the urinary system. These surgical procedures are performed in the surgical center under anesthesia, have a low risk of complications and rapid recovery. Learn more about the types of endoscopy available.

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