Wednesday, April 19, 2017

Kidney Stones : understanding, symptom, Cause, diagnosis, Treatment, complication and Prevention

Understanding Kidney Stones

Kidney stone disease or nephrolithiasis is a condition when a hard material that resembles a stone formed in the kidney. The material comes from residual waste substances in the blood that is filtered by the kidneys which are then deposited and crystallize over time.

In most cases, kidney stone disease experienced by people aged 30-60 years. An estimated 10 percent of women and 15 percent of men have experienced this condition during their lifetime.
Sedimentary rocks in the kidneys can be caused by food or other underlying health problems. Based on the type, kidney stones are divided into four, namely calcium stones, uric acid stones, struvite stones and cystine stones.

Symptoms of kidney stones

Symptoms usually due to kidney stones will not be felt if the sufferer of kidney stones is very small so it can get out of the body naturally through the ureters with ease. The ureters are channels that connect the kidneys to the bladder.
Symptoms of kidney stones can only be felt if the stone is larger than the diameter of the ureter tract. Large stone will rub against the wall lining of the ureter, causing irritation and even injury. Therefore, urine can sometimes contain blood. In addition, to irritating the ureter, kidney stones can also be stuck in the ureter or urethra (the tube urine discharge end) so that the accumulation of bacteria and can cause swelling due to infection. Symptoms of kidney stones that can arise when rubbing with ureter stones are the pain in the waist, lower abdomen or side, and groin can be accompanied by nausea.
While symptoms can be felt if the kidney stone patients experiencing kidney infection among urine looks cloudy and smells, weakness, chills, and fever is high.

Kidney stone patients in Indonesia

According to data collected by Indonesian Ministry of Health (MoH) in 2013, an estimated prevalence of patients diagnosed with kidney stones for those aged over 15 years amounted to 0.6 percent of the total population of Indonesia. Five provinces which occupy the highest position in the kidney stone disease problems among which are DI Yogyakarta, Aceh, West Java, Central Java and Central Sulawesi.

The diagnosis of kidney stones

In diagnosing kidney stones, usually, first the doctor will ask the patient about-about symptoms have been experienced. Doctors can also ask whether the patient had been suffering from kidney stones before, have a family history of the similar disease, or whether patients often eat foods or supplements that can trigger the formation of kidney stones.
Once the information is collected, the doctor will usually perform a number of tests to strengthen the evidence. The tests may be urine, blood tests, and scanning (eg, ultrasound, X-rays, CT scans, and intravenous urogram / IVU )

Treatment of kidney stones

Treatment of kidney stones is done depends on the size of the stone. If a kidney stone is still relatively small or medium-sized, and they can pass through the urinary tract without surgery, your doctor will usually advise patients to drink water only appropriate recommended dose. With the flow of fluid is continuously expected kidney stones can be pushed out by itself. If the symptoms are felt by patients is quite disturbing, doctors usually prescribe enough painkillers, such as acetaminophen, ibuproven or non-steroidal anti-inflammatory drugs.
Treatment of kidney stones with a special procedure (eg with laser energy, ultrasound, or surgery) will usually only be applied if larger sized stones that clog the urinary tract of the patient.

Prevention of kidney stones

How to prevent kidney stones is actually quite simple. You just need to drink enough water every day and limit consumption of foods, beverages, or supplements that contain substances that could potentially cause the formation of kidney stones, such as substance oxalate, supplementation of calcium and animal protein.
In addition to drinking enough water and limit the intake of certain substances, prevention of kidney stones can also be done by taking drugs prescribed by doctors. This step is usually recommended to prevent relapse for those who have previously suffered from kidney stones.

Symptoms Of Kidney Stones

Symptoms of kidney stones will not be felt if the stone size is relatively small and can get out of the urinary tract along with urine flow smoothly. Symptoms can only be felt when the stones stuck in the kidney, oversized stones pass through the ureters, causing an infection or kidney stones.

The ureter is a tube that connects the kidney to the bladder. This organ shape resembles a tube with sensitive tissue structures. When a large kidney stones pass through the ureter, the stone will rub against the wall of the ureter, causing irritation and risking injury. This is why sometimes urine may contain blood. If the stone is large enough, a stone may become lodged in the ureter so that disrupt the smooth flow of urine from the kidneys.
Symptoms of the most common kidney stone is a persistent pain in the abdomen side, lower back, hips, groin, or even testes (in men). In addition, other symptoms of kidney stones that may be present are:
  • Increased frequency of urination and pain during urination.
  • The color of urine looks cloudy and smell bad. Murky colors like brown or reddish in the urine can be caused by the bleeding while passing kidney stones urinary tract.
  • Nausea and vomiting may be present.
  • Restless.
  • Restlessness as difficult to find the right position to do so.
Kidney stone lodged in the ureter and make urine flow is not smooth can cause a buildup of dirt. This dirt buildup can cause the proliferation of bacteria which may ultimately result in a kidney infection. If kidney infection has occurred, then the symptoms can be experienced by patients are fever, body feels weak, the body feels cold even to shiver, urine looks cloudy and smells bad, and diarrhea.

Causes Of Kidney Stones

Naturally, the kidneys clean the blood by filtering daily waste substances contained in it to further disposed of in the form of urine. Sometimes these substances levels are too much compared to the liquid that serves as a solvent that can not be completely wasted by the body and settles in the kidneys. Other factors are the shortage of kidney function to prevent clumping precipitated crystals form stones.

Sedimentary rocks in the kidney can be caused by food or other underlying health problems. Based on its constituent materials, kidney stones can be divided into four main types, namely calcium stones, uric acid stones, stone ammonia (struvite), and cystine stones.
Calcium stones caused by high levels of calcium in the urine. These types of kidney stones are the most common. High levels of calcium can be caused by a hereditary disease hypercalciuria. This condition causes the sufferer to release much calcium in the urine. High levels of calcium can also be caused by an overactive parathyroid gland. Hormones produced by these glands function to regulate the amount of calcium in the blood.
The second is uric acid stones. These stones are formed due to high levels of uric acid in the urine caused by foods high in purines high. Examples of foods that trigger high uric acid are shellfish, meat, and fish. Gout sufferers are also at high risk of forming stones of this type.
The third is struvite stones. This is a type of kidney stones that can be formed and swell rapidly. The main cause struvite stone formation is a urinary tract infection that has lasted a long time. This rock type is more common in female patients than male patients.
The latter are cystine stones. Kidney stones are formed due to the excessive number of amino acid cystine that is excreted by the kidneys. Cystine stones is a type of kidney stones are very rare. This condition is caused by a disease known as cystinuria. This disease affects the amount of the amino acid cystine in the urine issued.
In addition to dietary factors and underlying health conditions, there are several other factors that can lead to kidney stones, among them:
  • Lack of drinking water
  • Family medical history
  • obese
  • Taking drugs, such as diuretics, aspirin, antibiotics, antacids, and some antiepileptic drugs and antiretroviral
  • The side effects of surgery on the digestive organs
If you've ever suffered from kidney stones, then you have the opportunity to re-exposed to the same conditions. Here are the factors triggering the recurrence of kidney stones.
  • Too many foods that contain too little protein and fibrous foods.
  • It has only one functioning kidney.
  • have experienced multiple infections associated with kidney or urinary system.
  • Having a family history of kidney stone disease.
  • Had undergone surgery on the digestive system.
  • Routine taking supplements containing calcium.
  • Taking drugs aspirin, certain classes of antibiotics, antacids, diuretics, antiepileptic drugs, and drugs for HIV.

Diagnosis Of Kidney Stones

In diagnosing kidney stones, your doctor will first try to dig information about the patient in advance of symptoms they experienced. Usually, the doctor will also ask if the patient had been suffering from kidney stones, have a family history of kidney stones disease, or if patients eat foods or supplements often perceived can trigger the formation of kidney stones.

Once the information is collected, a number of selection tests will be performed to confirm the diagnosis. The test may be urine, blood tests, and scanning (eg, ultrasound, X-rays, CT scans, and intravenous urogram / IVU). A urine test is performed to determine the presence of urinary tract infections associated with kidney stones. In addition, if a urine sample containing kidney stone chips, these tests can help physicians recognize the type of kidney stone formation.
As for the blood tests, the method is performed to help the doctor determine the levels of certain substances that could potentially cause kidney stones, such as levels of calcium or uric acid in the blood. In addition, blood tests are also done to determine whether a patient's kidney was still functioning properly or have been damaged.
The latter is an examination through picture image with X-ray, CT scan or intravenous urogram (IVU). An examination that can only be done at this hospital actually has the same goal, which is to ensure the existence and determine the position of kidney stones and accurately.
The analysis will greatly assist the physician in determining treatment or medicines in accordance with the conditions of patients with kidney stones. To note, at this time CT scan was more often used as the main selection by the physician in the diagnosis of kidney stone disease because the results are more accurate than other methods of investigation.

Kidney Stone Treatment

Treatment of kidney stones depends on the size of the stone. If still relatively small, kidney stones can still go out through the urinary tract without surgery. Your doctor will usually advise patients to do the proper treatment precautions, by drinking enough water every day. With the flow of liquid continuously, it is expected that small kidney stone can be pushed out by itself.

If the white water is considered not enough, your doctor may prescribe medication to help launch expenses of kidney stones, eg alpha inhibitors. This drug helps make the muscles relax so ureter kidney stones can come out without causing pain and in a relatively fast tempo.
If the patient's symptoms are felt already disturbing enough, enough doctors usually prescribe painkillers, such as paracetamol, ibuprofen and non-steroidal anti-inflammatory drugs. In addition to painkillers, the doctor will also provide an antiemetic drug to treat the symptoms of nausea and vomiting.
Your doctor will refer the patient to the hospital when the kidney stone disease is already causing severe pain. This is necessary especially if the patient has other conditions (such as being pregnant, vomiting to cause dehydration, aged over 60 years, and has only one kidney). In addition, the doctor will usually refer patients to the hospital if the pain symptoms worsen despite being given pain medication.

Treatment of kidney stones with surgery

Treatment of kidney stones with the new operation will be applied if the stone is large (approximately 0.6 centimeters or more in diameter) thus blocking the urinary tract of the patient. Type of treatment will depend pad the location and size of the stone. Procedures for handling large kidney stones are:
  • Extracorporeal shock wave lithotripsy (ESWL), namely the procedure for destruction of kidney stones by using high-frequency sound waves (ultrasound). Crushed stone that the fractures can come out easily.
  • Ureteroscopy, namely the appointment procedure of kidney stones by using a tool called ureteroscopy inserted into the ureter through the urethra and bladder. The urethra is the latest channel to discharge urine from the bladder to outside the body .. Once the location is known, the stone will be destroyed by using other instruments or laser. Ureteroscopy usually has done to deal with the stone stuck in the ureter.
  • Open surgery. In modern times, as now, this procedure has actually been relatively rare and only performed to remove kidney stones that are very large. As the name implies, open surgery is done by making an incision on the surface of the skin on the back that serves as an access for the surgeon to lift the kidney stones.
  • Percutaneous nephrolithotomy or abbreviated PCNL, namely the procedure for destruction of kidney stones. A small incision is made above the surface of the skin near the kidney, so a tool called nephroscope can go to break and lift the kidney stone chips. This procedure is usually done if action ESWL does not allow to be done, for example in the obese.

Complications Of Kidney Stones

Tibul complications in patients with kidney stones can be caused by a kidney stone itself or as a result of kidney stones treatment therapy.

Complications Due to Kidney Stones

Stone formed in the kidney have varying sizes, ranging from the size of grains of sand to gravel or greater. Stone surface also vary. Some types of kidney stones have smooth surfaces, while the other has an uneven surface. Large stones can irritate the urinary tract to injury when traversed by a kidney stone. Kidney stones can also be lodged in the urinary tract and obstruct the flow of urine so that the risk of kidney infection (pyelonephritis) will increase. Kidney infection can result in the spread of bacteria and other microorganisms in the blood. In addition, kidney stones can also cause permanent damage to the kidneys.

Complications Due to Kidney Stone Treatment

This type of therapy, as well as the location of the kidney stone, will affect the types of complications that arise. Some of them are
  • Sepsis. Bacteria and microorganisms contained in the kidney can escape into the bloodstream and cause infection. The symptoms will arise throughout the body.
  • painful
  • Injury to the ureter
  • Bleeding due to surgery

Prevention Of Kidney Stones

How to prevent kidney stones is actually quite simple. The first is to drink enough water every day. Besides being able to prevent dehydration, drink enough water can dilute your urine so the waste substances are filtered from the blood kidney is not easy to settle and always wasted smoothly.

The second preventive measure is to limit the consumption of food, drinks, or supplements that contain substances that could potentially cause the formation of kidney stones. For example as oxalate, animal protein, and calcium supplementation. Also, choose foods with a low salt content.
Examples of foods or drinks that contain oxalates are:
  • Legumes, including soybeans processed products
  • Sardine
  • Chocolate
  • black tea
  • tuber
  • Spinach
  • Grapes
  • Asparagus
Fixed consumption of foods containing calcium, because the body needs calcium to maintain bones and teeth. Consult your doctor or dietitian about nutrients that are better met by the patientAlso discuss with your doctor first, if you want additional calcium supplements.
In addition to drinking enough water and limit their intake of certain nutrients, prevention of kidney stones can also be done by taking drugs prescribed by doctors. This step is usually recommended for those who have suffered from kidney stones so that the condition does not recur. An example is the administration of allopurinol to lower uric acid levels in the blood in order to prevent the formation of kidney stones uric acid, antibiotics to prevent urinary tract infections as a major trigger kidney stones struvite, diuretic drugs to the patient's disease hypercalciuria to prevent calcium kidney stones, and drugs cystine-lowering agent for preventing cystine kidney stones.

No comments:

Post a Comment