This is the 3763rd article of Da Medical Care
Sweating profusely, crying, and crying, this is not the propaganda of apocalyptic movies, but a disease that is often encountered in life - "kidney stones" - "kidney stones" . With the continuous changes in people's lifestyle and diet structure, the incidence of kidney stones is also quietly rising. The pain caused by kidney stones is very severe, and patients often lie on the ground and roll miserably. So what exactly are kidney stones, and how to prevent and avoid kidney stones? Let's walk into the kidney stone and look at its past and present lives.
Figure 1: Low back pain caused by kidney stones
1. What are kidney stones?
Kidney stones are diseases caused by abnormal concentration of crystal substances such as cystine, uric acid, oxalic acid, calcium and other crystalline substances in the kidneys, and are common clinical diseases. The most common stones are calcium oxalate stones.
Figure 2: Kidney stones
2. Manifestations of kidney stones
Common symptoms of kidney stone disease include hematuria, bloating, restlessness, nausea, vomiting, and low back and abdominal cramps, which may also be accompanied by symptoms of chills or fever. Sometimes, patients do not have a feeling of pain, but there will be symptoms of hematuria with a very small amount of blood, which is generally invisible to the naked eye, and when there is a co-infection, there will be symptoms of frequent urination and urgency. If treatment is not carried out in time, it is likely to cause urinary tract infection, which will lead to urinary tract obstruction, and patients with serious diseases will also cause damage to their kidney function and atrophy of the kidney parenchyma.
Figure 3: Manifestations of kidney stones
3. The formation process of kidney stones
The formation of kidney stones begins at the core of the stone, and the core of the stone is composed of particles filtered and precipitated by the number of shifting crystals. A small number of stones are composed of blood clot cell clumps, mainly exfoliated epithelial cells and various aquatic foreign bodies, including salts with the participation of the liquid matrix, gradually precipitated around the core of the stone, and gradually expanded to form stones. The formation of kidney stones is very complex, crystals in the urine, such as calcium phosphorus ions or cystine, uric acid, ammonium magnesium phosphate and apatite and other substances increase, exceeding the solubility in the urine, showing a supersaturated state, the emergence of crystal nuclei after the gradual formation of stones.
Figure 4: Types of kidney stones
4. Conditions prone to kidney stones
Kidney stones, like other diseases, do not occur randomly, and their appearance is associated with a number of specific conditions.
Figure 5: Conditions that predispose to kidney stones
(The right sign indicates that it is easy to suffer, and the wrong sign indicates that it is not easy to suffer)
(1) Gender
The prevalence of kidney stones is higher in men than in women. This may be related to the work of men, because men are more engaged in manual labor, long-term sweating, insufficient water supplementation, intake of high-protein and high-fat foods, eating more; in addition, male androgens increase the formation of oxalic acid, while female estrogen can increase the excretion of structural rafteric acid in the urine, which can inhibit the formation of calcium-containing stones in the urine.
(2) Eating habits
Eating habits are closely related to the onset of kidney stones
Excessive fat intake
Excessive fat intake is likely to lead to a gradual increase in body fat, and the increased fat will affect the calcium in the human intestine, causing it to gradually decrease, which in turn leads to a gradual increase in the absorption of oxalate. Therefore, when the urinary function is faulty, such as low urine output, less water drinking, and more sweating, it is likely to cause kidney stones in this case.
Sugar intake
Excessive sugar intake, especially lactose, leads to increased calcium absorption and increased concentrations of oxalic acid, which allows calcium oxalate to accumulate in the body and eventually leads to the formation of urinary stones.
Excessive protein intake
Excessive protein intake may gradually increase the composition of uric acid, oxalic acid, and calcium in the patient's urine and kidneys. If the excess uric acid, oxalic acid and calcium are not excreted from the human body in a timely and effective manner by using kidney function, it may promote the condition of kidney stones and ureteral stones. This is also the reason for the increase in the incidence of kidney stones after the improvement of modern people's quality of life.
(3) Drinking water
The increase in water intake can increase the amount of urine so that the crystal supersaturation in the urine is reduced, the dilution and dissolution of metabolites and the scouring effect of the urinary tract are enhanced, which is conducive to the timely discharge of small stones and has a positive effect on preventing the formation of various types of stones. The results of the study show that the average daily water intake is the protective factor for the occurrence of urolithiasis, when the water intake is greater than 2000ml/d, the incidence of kidney stones can be significantly reduced, and the proportion of patients who drink less than 1000ml/d is significantly increased, so drinking water greater than 2000ml/day is conducive to preventing the occurrence of kidney stones.
(4) History of urinary tract infection
Bacteria become the core of stone formation during urinary tract infections and are an important risk factor for promoting kidney stone formation. Some bacteria such as Proteus can produce a kind of urease, which increases the urine pH by breaking down urea, so that calcium and the like reach supersaturation and precipitate, wrapped in the surface of the bacteria and then form stones. In patients with a history of urinary tract infection on the surface of clinical statistics, the prevalence of kidney stones is significantly higher than that of those without history.
5. How to prevent kidney stones
Drink plenty of boiled water
Reasonable calcium supplementation
Limit sugar intake
Eat less foods high in oxalate
Eat less soy products
It is best not to drink milk before going to bed
Do not overdos to cod liver oil
Eat more black fungus
Increase the amount of daily activity
6. Common misunderstandings about kidney stones
(1) Kidney stones must be very painful? No pain is not kidney stones
Some kidney stone patients do not have painful symptoms, but there will be a very small amount of hematuria symptoms, at this time the human eye is generally invisible, once the infection will appear frequent urinary urgency symptoms, must be paid great attention to, otherwise it may lead to urinary tract infection blockage, and even kidney damage.
(2) Drinking more water can definitely cure kidney stones?
Figure 6: Kidney Stone Size (1)
Figure 7: Kidney Stone Size (2)
The principle of drinking water to drain stones is to increase the amount of water uptake and enhance the excretion function of the kidneys. But not all stones can be successfully excreted through urine.
Relatively small kidney stones: usually <0.6cm kidney stones, the distal urinary tract of the stones has no obstruction, secondary infection, conservative treatment methods can be selected, such as drinking more water, appropriate activity, oral medication for the treatment of stones, etc.;
Relatively large kidney stones: for example, > 1cm kidney stones, there is no way to excrete themselves through the ureter, you can choose the extracorporeal shock wave lithotripsy method for treatment; extracorporeal shock wave lithotripsy is a non-surgical treatment method, mainly through B ultrasound or X-ray to locate the stones in the body, the high-energy shock wave is focused on the stones, so that the stones are cracked, and the crushed stones are excreted through the ureters; you can also choose the method of in vivo lithotripsy, which is a surgical treatment method, mainly using ureteral hososcopy for lithotripsy The soft ureteroscope enters the renal pelvis along the urethra and ureter, crushes the stone when found, and removes it through a stone mesh basket;
Excessively large kidney stones: For example, kidney stones > 2 cm can be treated with percutaneous nephrolithotomy, which is a surgical treatment.
Therefore, not all stones can be cured by increasing drinking water and proper exercise, and it is necessary to choose the appropriate treatment method in combination with the situation of the stone, so as not to delay the best treatment time.
(3) Can kidney stones supplement calcium?
Figure 8: Can Calcium Supplementation Cause Kidney Stones?
The most common kidney stones are calcium oxalate stones, so many people want calcium supplementation to cause or kidney stones. In fact, on the contrary, through reasonable calcium supplementation, in the digestive tract, oxalate combines with calcium ions to form calcium oxalate precipitation, which is excluded from the body with feces, reducing the incidence of kidney stones.
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Author: School of Medicine, Tongji University
Miao Yong'en