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Sunday, June 10, 2012

KIDNEY STONES


KIDNEY STONES 
Kidney stones are hard, rock-like crystals of varying sizes and shapes. They occur when salts in the urine precipitate and form solid materials. Stones can vary in size from as small as a rice grain to as large as an apple or golf ball. There are four major types of stones:  

  • stones formed from calcium combined with oxalate or phosphate, this is the most common type 
  • struvite stones(Magnisium Ammonium Phosphate), which are caused by urine infection 
  • uric acid stones  
  • cystine stones, which are rare and hereditary.

Causes of Kidney Stones 
Various factors play a part in increasing the risk of stone formation for some people.The range of factors
include:

1. excess calcium, phosphate, oxalate and uric acid in the urine 
2. lack of stone inhibitors in the urine  
3. inadequate hydration 
4. some medications 
5. ongoing urine infection 
6. rare inherited conditions and  
7. family history of stone formation.  

Stones can also form if substances are at normal levels. The substances form crystals, which become anchored in the kidney and gradually increase in size, forming a kidney stone.

Normally the stone will move through the urinary tract and pass out in the urine. But, when it is stuck and blocks the urine flow then it causes pain. Large stones do not always pass through and may require a procedure or surgery to remove them.

The  following lifestyle habits that can increase kidney stone formation.

  • not drinking enough fluid; 
  • a diet with low levels of calcium; 
  • the use of calcium supplements; 
  • a diet with high levels of animal protein; 
  • a diet with high levels of sugars (glucose and fructose); 
  • a diet with low levels of phytate ((found in wheat, rice, rye, barley, and bean products). 

Medical conditions which can increase the risk of kidney stone formation are Primary hyperparathyroidism, Gout, Diabetes Mellitus, Obesity, Crohn‘s disease and gastric or intestinal bypass surgery.

Signs and symptoms 
Not all kidney stones cause discomfort but pain is normally the first sign.  Pain can range from a mild and barely noticeable ache to discomfort that is so intense it requires hospital treatment. Typically, the pain gets worse and better, but does not go away completely. Waves of severe pain, known as renal colic, usually last from twenty to sixty minutes. Pain can occur in the flank (the side,between the ribs and the hip) or the lower abdomen.

Treatment
Most stones can be treated without surgery  - 90% of stones will pass by themselves within 3 to 6 weeks.
A majority of patients suffering from kidney stones can be treated successfully by proper dietary regulations. These regulations will also prevent a recurrence of the symptoms. Only a few cases require surgery. The patient should avoid foods which irritate the kidneys, to control acidity or alkalinity of the urine and to ensure adequate intake of fluids to prevent the urine from becoming concentrated. The foods considered irritants to the kidneys are alcoholic beverages, condiments, pickles, certain vegetables like cucumbers, radishes, tomatoes, spinach, rhubarb, water-cress and those with strong aroma such as asparagus, onions, beans, cabbage and cauliflower, meat, gravies, and carbonated waters.

Prevention

#1. Once the kidney stone has been detected it is important to carry out appropriate blood and urine tests to identify any underlying health problem which can increase the risk of kidney stone formation  


#2. Urinary tract infections should be treated immediately and appropriately  


#3. Patients should avoid dehydration by having enough fluid intake so as to keep the urine output to more than two litres a day. This will lower the level of stone-forming chemicals and reduce the risk of stone formation 


#4. Patients should avoid the consumption of too much of tea and coffee and consume no more than one litre per week of drinks with phosphoric acid, which is used to flavour carbonated drinks such as cola and beer  


#5. Citrus fruits may reduce the risk of some stones 


#6. Reducing salt intake often lowers the risk of calcium containing stones 


#7. Changes in diet may have to be recommended depending upon the type of stone.  





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