Urinary lithiasis

It consists of the formation of stones (or stones) within the pathways that lead to urine, from the kidney to the urethra, through the ureter and bladder. The word calculus is used in medicine to name stones. There are six different subtypes of stones, the most frequent being calcium oxalate (more than 80%), followed by those of uric acid and phosphate.

  • Renoureteral colic.
  • Hematuria (urinating blood).
  • Repeated urinary tract infections.
  • Low back pain.
  • Lituria (urinating stones).
    The supersaturation of salts or solutes in the urine, especially when it is scarce, is usually the necessary mechanism for the formation of most urinary stones. Low fluid intake is the cause of this insufficient diuresis. Also involved metabolic and dietary factors. Although in most cases it is not possible to know the exact cause of stone formation, each subtype has its own predisposing factors, such as calcium metabolism and oxalate dysfunctions in calcium oxalate lithiasis, dietary abuse a Meat base in uric acid lithiasis, or urine infection in ammonium magnesium phosphate (struvite) lithiasis. Some stones are due to genetic (cystine) or drug causes.
  • Caucasian or Asian ethnic group.
  • Geographic area with hot or arid climate.
  • Diet, especially if it is rich in saturated, unsaturated fats, sugars and animal proteins. Calcium lithiasis is associated with high sodium intakes. Vegetables such as spinach, rich in calcium oxalate. At the same time, patients with lithiasis, in general, consume less volume of fluids compared to those who do not have this disease.
  • Urine stasis for any cause (urinary stenosis, prostatic hyperplasia, neurogenic bladder).
  • The increase in calciuria is caused by various factors, including primary hyperparathyroidism, idiopathic hypercalciuria, renal tubular acidosis, hyperoxaluria, hypocitraturia, hyperuricosuria and idiopathic lithiasis.
  • Frequent urinary tract infections by certain bacteria such as Proteus, Pseudomonas, Providencia, Klebsiella.
  • The tests to prove the existence of a urinary stone are simple abdominal radiography and renovesical ultrasound. Sometimes it is necessary to complete the study with tests such as abdominal CT or intravenous urography, which allow a better visualization of the anatomy and the exact size and location of the stones within the urinary tract. For the study and metabolic control of lithiasic disease it is necessary to perform a blood test and a 24-hour urine test. The composition of the calculation is determined with microscope observation and spectrometry.
    Loss of renal function, pyelonephritis, renal abscess, sepsis, death.
  • An effective way to avoid the formation of new stones is to drink plenty of fluids, especially water. It's about getting diuresis of about 2-3 liters a day. Avoid abuses with salt in meals, foods very rich in protein (meats) and industrial pastries are very useful general rules against all types of lithiasis. Calcium oxalate lithiasis can be avoided by taking potassium citrate and removing oxalate-rich foods such as spinach, parsley, chard, chocolate, pepper and nuts from the diet. In this type of lithiasis you can take foods with calcium, milk type and derivatives because it has been proven that not taking them facilitates the formation of new stones. Uric acid lithiasis can be avoided by increasing the pH of the urine by taking sodium bicarbonate or potassium citrate; and making serious corrections in the diet (eliminate red meat, seafood, offal, sausages and salted meat, as well as alcohol). The lithiasis of magnesium ammonium phosphate (struvite), due to the infection of urine, needs to treat this infection to prevent the stone from reappearing. Acidifying the urine with aceto-hydroxamic acid is a possible measure, although due to the toxicity of the drug it is little used today. In cystine lithiasis, the urine must be alkalized with potassium citrate and force fluid intake, and specific treatments such as D-penicillamine or azetozolamide are given, although with discrete results.
 
 
 

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