In this article, we discuss the stages of passing a kidney stone. Renal lithiasis, also known as kidney stone, nephrolithiasis, or kidney stone, is a very common disease, caused by the crystallization of mineral salts present in urine, which group together and literally form a small stone inside the ducts. urinary.
When this stone is large enough to block the flow of urine, the internal structures of the kidney can dilate, causing renal colic. A renal colic crisis is one of the most painful events that a patient can experience in life. The pain caused by kidney stones is often described as worse than childbirth, bone fractures, gunshot wounds, or burns.
How are kidney stones formed? / stages of passing a kidney stone
A kidney stone is exactly what the name says: a solid formation made up of minerals that arise within the kidneys. About 80% of stones are composed of calcium salts, such as calcium oxalate and calcium phosphate. There are also stones based on uric acid, struvite (magnesium + ammonium + phosphate), and cysteine.
Understanding the formation of the stones is simple. Imagine a glass filled with clear, transparent water. If we add a little salt, it will dilute and cloud the water a little. If we keep adding salt, the water will become less and less clear, to the point that the salt will begin to settle to the bottom of the glass.
Precipitation occurs when water becomes supersaturated with salt, that is, the amount of water present is no longer sufficient to dilute the salt.
This is the beginning of stone formation. The kidneys are responsible for maintaining the balance of various chemical substances in our body, such as mineral salts. Therefore, it is natural and expected that urine contains elements such as calcium, oxalate, uric acid, phosphate, and magnesium, just to name a few.
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However, when the amount of water in the urine is not enough to dissolve all the salts present in it, they return to their solid form and precipitate in the urinary tract. The salts and minerals precipitated in the urine tend to agglomerate, initially forming small crystals and then, as they settle, stones.
This precipitation of salts present in the urine occurs basically for two reasons: lack of water to dilute or excess salts to dilute. Most cases of kidney stones occur due to a lack of water to properly dilute urine, which is caused by low fluid intake.
However, there is a group of patients who, even drinking plenty of water throughout the day, continue to form stones. These individuals usually have alterations in the natural composition of the urine, presenting an excess of mineral salts, mainly calcium. The amount of calcium in the urine is so great that even with a good intake of water it continues to precipitate.
Having enough water in the urine is essential to prevent stone formation. Patients who often develop stones drink, on average, 300 to 500 ml less water per day compared to people who have never had a kidney stone.
As I just explained, having enough water in your urine is essential to prevent stone formation. Patients who often develop stones drink, on average, less than 300 to 500 ml of water per day compared to people who have never had kidney stones.
Patients who live in countries with tropical climates or work in very hot places should always try to stay well hydrated to avoid producing highly concentrated urine.
The type of fluid ingested can influence the risk of stone formation. We know, for example, that sugary drinks, cola-based or not, increase the risk of stone formation. Orange juice, which is rich in substances that inhibit the crystallization of minerals in the urine, seems to reduce the chance of stone formation.
Some studies suggest that in addition to water, coffee and teas (including the famous stonebreaker tea) may have some benefits. Grapefruit juice appears to be harmful, as it increases the risk of stone formation.
In relation to alcoholic beverages, there are controversies, with studies indicating an increase in stone formation and others suggesting a reduction in formation, especially with the consumption of wine. Vitamin C supplementation increases renal excretion of oxalate, and some studies suggest that excessive intake may increase the risk of calcium oxalate kidney stones.
Although the idea that it is necessary to drink two liters of water a day to keep the kidneys healthy is widespread in the media when it comes to nephrolithiasis, what is important is the volume of urine produced by the kidneys in 24 hours and not the volume of liquid ingested.
People who have had at least one episode of kidney stones or who have a family history of kidney stones should urinate at least 2 liters a day. Since no one will be collecting urine all day to measure volume, one tip is to monitor urine color. Well-diluted urine has a faint odor and a very clear, almost transparent color. If your urine is very yellow, this indicates dehydration.
In relation to diet, there are some habits that can increase the incidence of kidney stones, especially if the patient already has concentrations of calcium in the urine that are higher than the population average.
Diets rich in salt, proteins, and sugars are risk factors. Interestingly, although most stones are made of calcium and arise from excess calcium in the urine, there is no need to restrict their intake in the diet. Restriction, by the way, can be harmful.
If the patient is already losing excess calcium in the urine and does not replace it through diet, his body will look to the bones for the calcium it needs, which can lead to early osteoporosis.
The only care should be with calcium supplements, since their consumption, especially on an empty stomach, seems to increase the risk of kidney stones. Men who have gained weight rapidly or who are over the age of 40 are at increased risk of kidney stones.
Other medical conditions that increase the possibility of nephrolithiasis are:
- arterial hypertension
- Mellitus diabetes
- recurrent upper urinary tract infection
- primary hyperparathyroidism
- medullary sponge kidney
- renal tubular acidosis type 1
- inflammatory bowel diseases
- short bowel syndrome, bowel resection, or gastrointestinal bypass
stages of passing a kidney stone woman are also increasing day by day. It is important to remember that there are also kidney stones formed by the precipitation of some drugs in the kidneys. Several medications can have stone formation as a side effect. The most common include indinavir, atazanavir, acyclovir, triamterene, ciprofloxacin, silicates, and sulfonamides such as sulfasalazine and sulfadiazine.
Many patients have stones in their kidneys and have no symptoms. If the stone forms within the kidney and remains there, the patient may remain asymptomatic for years. Some people discover a kidney stone by chance during an abdominal imaging test, such as an ultrasound or CT scan, ordered for some other reason.
Very small stones, less than 3 millimeters (0.3 centimeters), can travel throughout the urinary system and pass in the urine without causing significant symptoms. The patient begins to urinate and suddenly notices that a pebble has fallen into the toilet.
The classic symptom of a kidney stone, called renal colic or nephritic colic, occurs when a stone that is at least 4 mm (0.4 cm) in size becomes impacted in the kidney or somewhere in the ureter (the tube that carries urine from the kidneys and the kidney to the bladder), causing obstruction and dilatation of the urinary system.
Different points of impaction of the kidney stone
The intensity of renal colic is variable. It can be mild and barely noticeable or so severe that intravenous medication is needed to relieve symptoms. Severe renal colic makes the patient restless, moving all the time, searching in vain for a position that will provide relief.
Unlike back pain, which improves with rest and worsens with movement, renal colic hurts intensely no matter what the patient does. Renal colic pain usually comes in waves, with periods of greater and lesser intensity, which can last between 20 and 60 minutes. ( read this article from this website.)
Most patients with renal colic have hematuria (blood in the urine) due to direct stone injury to the ureter. Other symptoms that may occur are nausea, vomiting, pain when urinating, and urinary urgency. If the stone is impacted in the lower half of the ureter, renal colic can radiate to the leg, the labia majora, or the testicles.
Renal colic usually has three stages:
The pain begins suddenly and reaches its maximum intensity in about 1 or 2 hours.
After reaching its apex, the pain remains intense for another 1 to 4 hours on average, leaving the patient extremely restless.
The pain begins to relieve itself spontaneously and over more than 2 hours it tends to disappear. In some unlucky people, the whole process takes more than 12 hours, if they don’t seek medical attention.
It is also possible that the stone can go through the entire ureter, being impacted only in the urethra, which is the point with the smallest diameter of the urinary system. In this case, the pain occurs in the pelvic region and is accompanied by burning during urination and bleeding. Often the patient can recognize that he has a stone in his urethra, about to come out.
Nephrolithiasis should be suspected in any patient with renal colic or pain in the flank (the lateral region of the body between the rib and the hip), with or without blood in the urine. The diagnosis of kidney stones is usually confirmed by medical history and imaging.
The best test is computed tomography (CT), which can identify stones anywhere in the urinary system, even without the use of contrast.
In situations in which it is not possible to perform a tomography, or if there is a contraindication to perform this examination, as, in the case of pregnant women, an ultrasound of the urinary tract is a good alternative. The disadvantage of ultrasound is its poor ability to identify impacted stones in the middle of the ureter since intestinal gas interferes with the formation of a clear image.
Imaging tests, in addition to diagnosing the stone, are also able to rule out complications, such as dilation of the urinary system (called hydronephrosis), detect associated clinical conditions, and measure the size of the stone, information that is important for the doctor to try to predict what will happen in the next few days. For more detailed information you can visit the kidney stone remedy official website here.
Natural history of calculus
Location and size are the factors that define whether the stone is likely to pass spontaneously or whether a urological procedure will be necessary to remove it.
Stones smaller than 5 mm (0.5 cm), especially if they are located in the final part of the ureter, usually pass spontaneously in the urine without the need for specific treatment. The stone takes, on average, 8 to 14 days to be expelled. However, depending on the location, the time can be up to a month.
Less than 20% of patients with stones smaller than 5 mm require any medical intervention to remove the stone. Starting at 5 mm, the larger the stone, the less likely it is to pass spontaneously. 60% of kidney stones between 5 and 7 mm (0.5 and 0.7 cm) pass without treatment; this rate drops to less than 50% for stones between 7 and 9 mm (0.7 and 0.9 cm) in size.
Large stones, larger than 9 mm (0.9 cm), only 25% pass spontaneously, even then, only if they are already in the final part of the ureter. Stones larger than 10 mm (1 cm) located at the beginning of the ureter, near the kidney, do not usually pass on their own, since they are up to three times larger than the average diameter of the ureter.
Typically, the patient is discharged home with anti-inflammatory drugs to control pain and drugs that relax the ureter, making it easier for the stone to pass into the bladder.
The most commonly used drugs for this purpose are tamsulosin (a drug that is also used in benign prostatic hyperplasia ) or nifedipine (a drug that is also used to treat high blood pressure ).
The patient should preferably urinate through a screen to recover the stone in case of elimination. The acquisition of the stone is of paramount importance for the analysis of its composition. ( read here some best articles from Wikipedia)
If the patient has stones larger than 1 cm, pain, nausea, or vomiting that does not go away with medication, signs of kidney obstruction (hydronephrosis), acute kidney failure, signs of urinary tract infection, or if the stone does not pass after 4 spontaneously at 6 weeks, evaluation by a urologist is indicated.
Are there medications that dissolve kidney stones?
If the stone is made up primarily of uric acid, alkalinizing the urine with bicarbonate of soda or potassium citrate (Litocit) may help dissolve the stone. This is the only situation in which it is possible to dissolve a kidney stone.
However, the vast majority of kidney stones are composed of calcium salts. In these cases, unfortunately, there is no way to dissolve the already-formed stones. Be careful. Some dishonest companies take advantage of the fact that most stones pass spontaneously and that some stones can change size to sell “natural miracle products”.
There are dozens of fake websites that recommend the use of substances that supposedly dissolve kidney stones. These treatments are not scientifically proven. No International Society of Urology or Nephrology recommends the use of substances to dissolve calcium-based stones.
And the stonebreaker tea?
The famous stonebreaker tea does not break any stone. But it appears to be effective in preventing kidney stones. If the patient already has a calcium stone formed, tea works just as well as any other liquid, including water. However, if taken frequently, it appears to decrease the formation of new stones, thus reducing the incidence of new kidney stones.
This information has been taken from different sources on the internet. please consult your doctor before taking any medicine or treatment in relation to your health issue. this is only an information base article.