Kidney stones are a problem that together a lot of people (12% of men and 6% of women), of which only one party is suffering from renal colic, an incident involving 1.2 million people each year, and that represents about 1% of the causes of hospitalization.
The renal colic strikes without notice, and is described as one of the most painful events that can happen: some have called the pain that you feel even worse than that of a gunshot wound.
The causes of renal colic: Kidney Stones
Kidney stones are solid formations composed of different minerals, which are formed by precipitation within the kidney or along the streets kidney. Calculations are indistinguishable in calcareous (containing calcium) and calcium.
The most common kidney stones are composed of calcium oxalate or phosphate. May be caused by, , hyperthyroidism or excessive synthesis of vitamin D3.
The chronic and recurrent urinary infections cause the calculations instead consist of magnesium ammonium phosphate. With the same frequency (5-10%) occur calculations formed by uric acid crystals. There are also rare kidney stones, which occur with a frequency of less than 1%.
The renal colic is usually the result of the mobilization of a kidney and almost always occurs with violent pain in the right or left lumbar region, radiating to the respective side and then to the genitals, often accompanied by nausea and vomiting.
The causes of renal colic: Kidney Stones
Kidney stones are formed when the concentration of a dissolved substance in the urine exceeds a critical value and can no longer remain in solution. To understand this phenomenon, try adding salt to the water, stirring to melt it: at some point, add the salt that is no longer able to melt and settles on the bottom: the aggregation of the salt deposited form the calculation.
This phenomenon can occur not only when there is an excess of an ion in the urine, but even when the physical and chemical conditions of urine (eg, PH) interfere with the solubility of the substance causing the precipitation and deposition calculations.
There is a strong hereditary and familial predisposition to stone formation, as well as other metabolic disorders (e.g. gout), the and, characterized by excessive production of substances that form stones.
the most common metabolic alteration in patients with calcium kidney stones. It is present when the urinary calcium excretion exceeds 200 mg in a 24-hour urine collection, or more than 4 mg / kg in 24 hours. May have different causes: on the one excessive absorption of calcium from the intestine to an absorption problem in the renal tubules.
Although thyroid dysfunction as hyperparathyroidism may be a risk factor for this type of calculations.
Some infections, however, lead to the formation of struvite (composed of magnesium ammonium phosphate), produced by some bacteria of the Proteus group. They are formed as a result of cystitis, and are therefore more common among female subjects.
The identification of kidney stones not expelled is not always easy, but is necessary due to renal colic.
The exams are the most widely used abdominal ultrasonography, radiography with or without contrast (the contrast medium is called IVU) and spiral CT.
Of these tests, only the TAC provides a near 100% probability of identifying the calculation, its size and its fragility, but is not used as the reference test because of the cost.
Treatment of kidney stones after colic
Kidney stones that block the urethra, with a diameter less than or equal to 5 mm are usually ejected automatically in 1-2 weeks, the treatment is therefore limited to hydration and analgesia, as the pain accompanying colic can be very strong. Up to expulsion took place, must be continued periodic monitoring, radiological or ultrasound.
Fluid intake should be considerable (6-8 glasses a day), so as to produce a large volume of urine. It can be effective so-called "blow water", which is to drink a quart / liter and a half of water quickly, so that it acts as a "push" and facilitate the expulsion of the calculation.
If the calculation is not broken down by itself, there are several possibilities, to the minimally invasive surgery, here are the three most commonly used treatments.
Extra corporeal shock wave lithography: the case of shock waves generated by a special instrument, which are dress on the calculation. The treatment requires no anesthesia, but only a mild painkiller, but it is effective only in case of kidney stones do not exceed 1.5 cm.
Performed under anesthesia, an instrument reaches the calculation in the urinary tract and grinding using a laser, the calculation is then extracted with special tools. Effective in all urinary tract stones and some of the kidney.
Percutaneous treatment: the calculation is crushed and extracted with a tool that enters the kidney from a small hole in the side. Must be performed under general anesthesia and is indicated in the case of calculations that were not crushed by extra corporeal shock wave lithotripsy.
The renal colic strikes without notice, and is described as one of the most painful events that can happen: some have called the pain that you feel even worse than that of a gunshot wound.
The causes of renal colic: Kidney Stones
Kidney stones are solid formations composed of different minerals, which are formed by precipitation within the kidney or along the streets kidney. Calculations are indistinguishable in calcareous (containing calcium) and calcium.
The most common kidney stones are composed of calcium oxalate or phosphate. May be caused by, , hyperthyroidism or excessive synthesis of vitamin D3.
The chronic and recurrent urinary infections cause the calculations instead consist of magnesium ammonium phosphate. With the same frequency (5-10%) occur calculations formed by uric acid crystals. There are also rare kidney stones, which occur with a frequency of less than 1%.
The renal colic is usually the result of the mobilization of a kidney and almost always occurs with violent pain in the right or left lumbar region, radiating to the respective side and then to the genitals, often accompanied by nausea and vomiting.
The causes of renal colic: Kidney Stones
Kidney stones are formed when the concentration of a dissolved substance in the urine exceeds a critical value and can no longer remain in solution. To understand this phenomenon, try adding salt to the water, stirring to melt it: at some point, add the salt that is no longer able to melt and settles on the bottom: the aggregation of the salt deposited form the calculation.
This phenomenon can occur not only when there is an excess of an ion in the urine, but even when the physical and chemical conditions of urine (eg, PH) interfere with the solubility of the substance causing the precipitation and deposition calculations.
There is a strong hereditary and familial predisposition to stone formation, as well as other metabolic disorders (e.g. gout), the and, characterized by excessive production of substances that form stones.
the most common metabolic alteration in patients with calcium kidney stones. It is present when the urinary calcium excretion exceeds 200 mg in a 24-hour urine collection, or more than 4 mg / kg in 24 hours. May have different causes: on the one excessive absorption of calcium from the intestine to an absorption problem in the renal tubules.
Although thyroid dysfunction as hyperparathyroidism may be a risk factor for this type of calculations.
Some infections, however, lead to the formation of struvite (composed of magnesium ammonium phosphate), produced by some bacteria of the Proteus group. They are formed as a result of cystitis, and are therefore more common among female subjects.
The identification of kidney stones not expelled is not always easy, but is necessary due to renal colic.
The exams are the most widely used abdominal ultrasonography, radiography with or without contrast (the contrast medium is called IVU) and spiral CT.
Of these tests, only the TAC provides a near 100% probability of identifying the calculation, its size and its fragility, but is not used as the reference test because of the cost.
Treatment of kidney stones after colic
Kidney stones that block the urethra, with a diameter less than or equal to 5 mm are usually ejected automatically in 1-2 weeks, the treatment is therefore limited to hydration and analgesia, as the pain accompanying colic can be very strong. Up to expulsion took place, must be continued periodic monitoring, radiological or ultrasound.
Fluid intake should be considerable (6-8 glasses a day), so as to produce a large volume of urine. It can be effective so-called "blow water", which is to drink a quart / liter and a half of water quickly, so that it acts as a "push" and facilitate the expulsion of the calculation.
If the calculation is not broken down by itself, there are several possibilities, to the minimally invasive surgery, here are the three most commonly used treatments.
Extra corporeal shock wave lithography: the case of shock waves generated by a special instrument, which are dress on the calculation. The treatment requires no anesthesia, but only a mild painkiller, but it is effective only in case of kidney stones do not exceed 1.5 cm.
Performed under anesthesia, an instrument reaches the calculation in the urinary tract and grinding using a laser, the calculation is then extracted with special tools. Effective in all urinary tract stones and some of the kidney.
Percutaneous treatment: the calculation is crushed and extracted with a tool that enters the kidney from a small hole in the side. Must be performed under general anesthesia and is indicated in the case of calculations that were not crushed by extra corporeal shock wave lithotripsy.
No comments:
Post a Comment