Currently, urolithiasis is notis a rarity. One of the types of pathology are oxalates in the kidneys. They are diagnosed quite often and represent a danger not only to health, but also to the life of the patient. This is due to the fact that this type of calculus has a dense structure, in addition, the surface of oxalates is covered with spikes. Formations injure the mucous membrane of the organ, thereby provoking the development of internal bleeding, which is extremely difficult to stop. Oxalate kidney stones are difficult to treat by conservative treatment. In most cases, when confirming the diagnosis, surgical intervention is indicated.
The mechanism of the disease
Epithelial tissue of the urinary organsthe system normally has a peculiar barrier due to which the formation and accumulation of salts does not occur. Under the influence of various unfavorable factors, the fulfillment of the protective function is disrupted. As a result, a series of chemical reactions is initiated, the consequence of which is the formation of dense crystals. In the presence of an inflammatory process or with an increase in the degree of concentration of urine, the formations move to the renal pelvis and settle into them. Over time, the crystals expand and become oxalate nuclei.
Concretions can be of various sizes - from1-2 mm to 4-5 cm in diameter. In the kidneys, oxalate stones are usually brown and black in color. The dark shade indicates that the mucous membrane of the organ was already damaged by the stones. Less common are light brown stones, the color of which indicates that they have not yet become the cause of internal bleeding.
The surface of oxalates is covered with spikes and growths, and therefore they are considered the most dangerous. If the stones occupy the entire cavity of the kidney, an emergency surgical intervention is indicated.
Reasons for education
The development of pathology occurs under the influence ofboth external and internal factors. The most common causes of the formation of oxalate kidney stones are the following diseases and conditions:
- hereditary predisposition;
- disturbance in the body of oxalic acid metabolism;
- magnesium deficiency;
- inflammatory processes in the urinary system;
- surgical interventions in the gastrointestinal tract;
- diabetes;
- unbalanced nutrition;
- Crohn's disease;
- deficiency of vitamins C and B6;
- long stay in a state of stress.
In addition, the composition of the soil and water in the region of permanent residence affects the development of pathology. In some areas, residents receive minerals in excess of normal levels.
Symptoms
The severity of signs of the presence of oxalate stones in the kidney is directly dependent on the size of the stones. If they are only in the formative stage, the person may experience the following symptoms:
- Pain in the side. By the nature of the manifestation, it is dull and mild.
- Discoloration of urine. Urin acquires a rich yellowish-red hue. Urine also becomes turbid.
Over time, oxalate kidney stones expand. The process is accompanied by the occurrence of pronounced symptoms. At this stage, the patient appears the following signs of pathology:
- Hematuria. This is a condition characterized by the presence of blood in the urine. Liquid connective tissue enters the urine due to injury of the concrements of the inner lining of the body by spikes.
- Pain in the side. They are expressed very brightly, gradually increasing and may end in a fit of renal colic.
- Frequent episodes of relapse of existing pyelonephritis.
- General malaise.
- Strong feeling of fatigue.
- Frequent urge to urinate.
Often increased pain and the appearance of blood in the urinearise after physical exertion, long walks, jogging or traveling by transport on uneven roads (which is accompanied by shaking and, accordingly, the displacement of stones).
Diagnostics
Information on how to displayoxalate kidney stones, provided by a nephrologist. It is necessary to refer to it at the first alarming symptoms. In the process of the initial admission, the doctor will collect anamnesis and examine the patient, after which he will issue directions for laboratory and instrumental examinations.
Clinically significant for the disease is a common urine test. The specialist is interested in the following changes confirming the diagnosis:
- Hyperoxalaturia. This is a condition characterized by excessive accumulation of oxalic acid in the body, which then enters the bloodstream and is eliminated by the kidneys in the urine.
- Microhematuria. It is characterized by the presence of blood impurities in the urine. In this case, the liquid connective tissue in the urine cannot be seen with the naked eye.
- Weak proteinuria. In this state, together with urine, a protein comes out of the body, the amount of which exceeds normal values.
- The presence in the urine of glycolate and glyoxylic acid.
- Increased degree of ability of crystal formation in urine.
- Moderate tubular dysfunction.
- The presence of markers indicating instability of cell membranes.
Urinalysis is the most accessible type of research, allowing not only to confirm the diagnosis, but also to determine the chemical composition of the stones.
The instrumental methods for diagnosing pathology include the following:
- radiography of the kidneys;
- bakposev urine;
- Ultrasound;
- scanning of the urinary system;
- contrasting techniques;
- chromocytoscopy;
- urography
The expediency of the appointment of certainResearch is determined by the doctor. They are necessary in order to identify the exact location of the stones, their number, size and shape. Based on the results of the diagnosis, the most effective treatment regimen is compiled. In addition, the question of the feasibility of surgical intervention is being addressed.
Medication
Oxalate kidney stones are extremely difficult to treat. Appointment of medication is justified only in the case when the size of the stones is small and there are no complications.
A pathology treatment regimen implies the use of agents that have the following effects:
- Pain reliever, especially when episodes of renal colic occur.
- Anti-inflammatory.
- Improving urine flow.
- Conducive to the natural release of calculus from the body.
- Litolytic.
Most often, nephrologists prescribe the following drugs:
- "No-shpa" (antispasmodic).
- "Baralgin" (analgesic).
- "Blemarin" (a drug designed to detect oxalate kidney stones and their dissolution).
- Containing vitamins E and A (normalize the rate of metabolic processes).
- "Fitolysin" or "Cystone" (promote the excretion of uric acid).
- Containing vitamin b6 (stops the growth of oxalates).
- "Asparkam" (compensates for the deficiency of magnesium and potassium in the body).
In addition, for the treatment of pathology is assigneduse of special mineral waters. In their composition there are only those components that can improve the course of the disease. Doctors recommend the following mineral water names for oxalate kidney stones:
- "Essentuki number 4".
- "Obukhovskaya".
- "Narzan".
In addition, this physiotherapeutic method can be used as a preventive measure for the onset of a disease or its recurrence.
If taking medication for oxalate stones in the kidneys did not lead to a positive result, the doctor decides whether it is advisable to perform an operation to remove calculi.
Surgical intervention
Currently, there are several methods of getting rid of stones:
- Traditional (open).
- Shock wave lithotripsy.
- Endoscopic.
Традиционное хирургическое вмешательство involves the removal of calculi from the kidneys through direct access to the body, obtained through the violation of the integrity of the skin. Surgeons resort to this method only in emergency cases, preferring more gentle methods.
Indications for open surgery are the following states:
- very large oxalates;
- acute pyelonephritis;
- recurrence of urolithiasis.
The essence of the method is as follows:anesthesia is administered to the patient, then the surgeon cuts the skin, fat layer and muscle tissue with a scalpel. After this, the kidney is cut and stones are removed. The final step is stitching tissues and installing a drainage system.
Currently, the method is used extremely rarely, due to its shortcomings:
- the need for general anesthesia;
- high risk of postoperative complications;
- long rehabilitation period.
The advantage of an open operation is a quick relief from calculus and, accordingly, painful symptoms for the patient.
Более современным методом является shock wave lithotripsy. This method involves the fragmentation of kidney stones by ultrasound. With the help of the technique it is possible to get rid of small stones only.
Ударно-волновая литотрипсия проводится следующим way: next to the patient's body is installed the device, which is intended for the accumulation of kinetic energy. Stones disintegrate into tiny particles under the power of ultrasound directly directed to the stones. As a result, the resulting sand leaves the body in a natural way during the act of urination.
The advantages of the technique include the absence of a rehabilitation period and the need for general anesthesia. Immediately after surgery, the patient can begin his normal activities.
Crushing kidney stones with ultrasound is notcarried out in persons with a history of: coagulation disorders of the liquid connective tissue, a tendency to develop bleeding, pathology of the digestive system, malignant neoplasms, severe diseases of the cardiovascular system.
There are several ways to endoscopically remove calculus:
- Percutaneous nephrolithotomy.
- Urethroscopy.
The first option is shown to persons with kidney problems.stones in size from 1.5 to 2 cm in diameter. Its essence is as follows: the doctor makes several small incisions in the abdominal cavity, through which endoscopic instruments are inserted, creating a channel through which grinding and removal of oxalates takes place.
Urethroscopy is used if the sizestones in diameter does not exceed 1.5 cm. The operation is as follows: a thin tube, equipped with a camera, is inserted into the kidney. After that, with the help of a tool, the doctor gets the opportunity to crush the stones into the smallest particles that can later be released naturally.
The main disadvantage of the method is the necessity of administering anesthesia to the patient. In addition, during the operation, the integrity of body tissues is disturbed.
Traditional methods of treatment
Важно понимать, что нетрадиционные методы не release the patient from the need to seek qualified medical care. The main goals of alternative treatment are: improving the condition of oxalate stones in the kidneys, their dissolution and excretion in a natural way. It must be remembered that this type of calculus is extremely difficult to conservative methods of therapy, in connection with which traditional methods can be used only to alleviate the symptoms of the disease or to get rid of fine sand that has not had time to form into a dense formation.
The most effective recipes:
- In 200 ml of milk (it is recommended to give preference to goat) dilute 2 tsp. honey The tool must be taken in the morning and on an empty stomach. The course of treatment is 2 months.
- Well help alleviate the symptoms of oxalic acid.kidney stones grass. You should regularly take decoctions of the following medicinal plants: nettle, bearberry, peppermint, black elderberry, buds and birch leaves. The tool can be both single and multicomponent.
Before using any unconventional methodsmedicine must consult with your doctor. Only he can give a definite answer as to what can be used with oxalate kidney stones, and what is not.
Features of nutrition
During the treatment of pathology is especially seriousIt is necessary to treat the power adjustment. With oxalate stones in the kidneys, the diet can significantly improve the condition of the patient and prevent the formation of new stones.
The diet must contain the following products:
- boiled meat (chicken, turkey, pork, lean, beef);
- milk (with an increased level of calcium in the urine is prohibited);
- oil of both vegetable and animal origin;
- bran bread;
- cereals (buckwheat, barley);
- dried fruits compote;
- pasta;
- vegetables (preference is recommended to give pumpkin, potatoes and cucumbers);
- fruit;
- nuts.
In the menu with oxalate kidney stones in no wayIn this case, one should not include offal, fish, salted cheese, smoked and spicy dishes, canned food, meat broths, coffee, jam, cocoa, mushrooms, chocolate, baking, some berries and fruits (strawberries, pears, blueberries and gooseberries).
Prevention
To prevent the recurrence of the diseasedrink as much as possible (up to 3 liters) of clean non-carbonated water. To enhance the process of removing sand, it is recommended to regularly perform simple physical exercises. In addition, you must follow the diet shown in oxalate stones in the kidneys. The implementation of these rules significantly reduces the risk of calculus formation.
Finally
Oxalate kidney stones are denseformations with an uneven surface. They are formed under the influence of various adverse factors. Concrements of this type are extremely difficult to treat with conservative methods. With the ineffectiveness of drugs, surgical intervention is indicated.
