Renal lithiasis is a disease consisting of the presence of “kidney stones” in the urinary system, formed by the bladder, kidneys, and ureters, which can originate pain, obstruction, bleeding or even an infection. These kidney stones are formed in the kidney from substances that are part of the urine and that the kidney itself removes.
Kidney stones can be as small as a grain of sand or several centimeters and kidney stones can be caused by a series of factors, such as the following:
-Diet (excess of calcium, oxalates, proteins, poor fluids intake).
-Sedentarism (lack of physical activity).
-Ingestion of certain medications (calcium antagonist, a high intake of vitamin C y D).
-Recurrent urinary infections.
-Anatomical alterations (being this factor the least common).
In its appearance kidney stones are influenced by genetic, environmental and eating habits. The low intake of liquid is the most important factor in the origin of the problem. In fact, people who live in arid areas or at high temperatures are more likely to produce stones.
The kidney stones are composed of different minerals such as calcium, oxalate, uric acid, and others, which are coupled to form structures of various sizes and shapes.
How Do you Detect Kidney Stones?
It is estimated that between 10 and 15% of the population may have kidney stones and they have different symptoms depending on the location and size of the stone.
A kidney stone of the size of a grain of sand or up to 3 mm can go unnoticed and be removed spontaneously, or cause great pain. In contrast, a 2 cm stone may not provoke symptoms if it is located in the kidney.
Most of the time, these kidney stones are removed spontaneously, while, on other occasions, obstruct the passage of urine.
The size of the kidney stone depends on the time spent in the urinary tract, the location, and the space it has to grow. For example, the most voluminous stones are in the kidney that has cavities that expand due to obstruction and allow the growth, also in the bladder due to lack of a good emptying of the latter.
When the urinary tract is blocked, a great pain is felt, known as “renal colic”. This pain is usually located in the back, under the ribs, the anterior part of the abdomen on the same side and radiates to the genital area. There may also be nausea, blood in the urine and vomiting.
Imaging, blood and urine tests help to detect the size and location of kidney stones and, thus, help to plan treatments.
Generally, patients who are suffering from renal colic, arrive at the emergency service with a lot of agitation, so they are administered intravenous analgesics to control the crisis.
The clinical diagnosis is complemented by other tests that seek to identify the characteristics and location of the kidney stone. An abdominal scanner, urine and blood tests are indicated to rule out associated complications such as urinary infection or kidney failure.
The scanner makes an anatomical reconstruction by taking thousands of images that merge without losing even a single millimeter of the evaluated area. This test is able to detect almost all types of stones.
In the urine test to detect stones, it usually shows the presence of red blood cells in what we call “hematuria”, which cannot be seen with the naked eye (microscopic hematuria). It can also show the presence of white blood cells and bacteria. The latter suggests that the patient is facing a severe complication such as obstruction of the urinary tract and the inability to evacuate infected urine. This can cause affected kidney failure and septicemia that can put the patient’s life at risk.
Renal colic can be as painful as trigeminal nerve neuralgia or a delivery without anesthesia. However, despite its frequency in most patients, there can even be kidney stones that will never give symptoms and that will only be diagnosed by chance while practicing an imaging test in that area.
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