One of the types of urolithiasis is urate kidney stones. This anomaly is the 2nd most common in humans. As a rule, it is recorded in the period from 20 to 55 years. Uric acid stones in elderly people are detected in the bladder, and in young people - in the renal organs and ureters. The formation of calculi that are not detected in time are dangerous with serious complications.
General information
Pathologies with metabolic disorders, as a result of which urate stones and other insoluble compounds in the renal organs are formed, are called urolithiasis. The formation of urates is typical for a strong half of humanity. Urate stones are colored yellow-brown with a relatively smooth structure. The kidney, ureter and ureter are the organs in which uric acid stones form. A dangerous deterioration is the transformation of urate stones into coral-shaped ones, which is fraught with diseases such as pyelonephritis and chronic renal failure.
Causes of uric acid kidney stones
An insufficient amount of B vitamins can provoke an anomaly. According to experts, the emergence of a pathological process in the form of the formation of urate stones in the body is facilitated by various reasons, acting in combination or separately, they include:
- Genetic predisposition. Urolithiasis is inherited, as an example, high levels of calcium in the body (calcium is building material for calculi in most cases).
- An increase in salt concentration due to a malfunction of metabolic processes. This will lead to disruptions in the natural balance of microelements, a salt precipitate will appear, from which stones will begin to form.
- Monotonous nutrition can serve as a factor in the development of stone formations.
- Place of residence of the person. There are geographical places in which cases of urolithiasis are more often recorded. To avoid this, the body should be kept hydrated.
- The specific composition of the water consumed can influence the progression of the disease.
- Insufficient amount of B vitamins.
- Favorable conditions for the development of the disease - hard work; passive lifestyle; bad habits, fasting.
- The use of a large amount of analgesic drugs.
- Acid reaction of urine. Acidic indicators can be identified using specialized rapid tests. Indicators are normally considered from 6.0 to 7.0.
- Excessive content of uric acid salts in urine. Salts are the end product of protein metabolism in the body, which is always present in urine. To change to an alkaline reaction, you should eat a lot of vegetables, fruits and dairy products.
Symptoms
Nausea and urge to vomit - possible symptoms the presence of urate stones in the body. The main danger in the formation of stones is that long time no symptoms appear. In the later stages, the main symptom of the presence of urate stones in the body is renal colic and its characteristic manifestations:
- sharp pains in the lumbar region;
- painful sensations spread to all organs of the genitourinary system (from the bladder to the adrenal gland);
- a painful attack cannot be stopped;
- the presence of tremors in the body;
- nausea and urge to vomit;
- excessive gassing;
- pain when urinating;
- gout;
- visual deviations from the parameters in urine (turbidity, sandy sediment, bloody spots).
An increase in body temperature is an alarming symptom that speaks of an incipient inflammatory process in the renal organs. The development of renal colic occurs during obstruction of calculus in the normal outflow of urine. At the first sensory or visual changes in the body, you should consult a specialist, the pathology detected in time is corrected much faster than a neglected state.
Diagnostics
For staging accurate diagnosis it is necessary to undergo examination. Men are more prone to the formation of urate stones in the body. They associate this with the fact that the male sex has a more pronounced preference for meat and dishes from it. The resulting excess of uric acid provokes the formation of urate calculi and gout. However, women are more likely to suffer a severe form of urolithiasis, namely, large coral-shaped stones. During the diagnosis and selection of effective therapy, one should take into account the existence of chronic diseases, namely coronary heart disease, diabetes mellitus, obesity, gout and hypertension. To make an accurate diagnosis, an examination is prescribed, consisting of:
- general blood test;
- deep laboratory studies of urine;
- urography (overview and excretory);
- ultrasound examination of the urinary system;
- spiral computed tomography (CT);
- magnetic resonance imaging (MRI);
- contrast fluoroscopy (conventional X-ray is not effective).
Pathology treatment
General principles of conservative treatment
The specificity of the uncomplicated degree of pathology in light dissolutions of urate formations. Conservative methods contribute to the development of a favorable outcome. Uric acid stones dissolve under the influence of the consumption of a large volume of liquid, which triggers a change - the acidic state is converted to alkaline. With this therapy, an important role is played by nutrition, namely, a large consumption of plant and dairy products is introduced into the human diet and the intake of alkaline mineral water. If such measures are not able to dissolve urinary salts, then treatment with medication or surgery is prescribed.
Drug therapy
Medicines can help relieve pain and inflammation. Treatment of urate kidney stones with drugs is aimed at:
- removal of pain attacks;
- correction of protein metabolism;
- an increase in the rate of formation and volumes of urine;
- removal of inflammatory processes (if any).
To achieve these goals, they resort to antispasmodic drugs to relieve muscle tension in the urinary tract; they turn to uricostatic drugs in case of violation of the exchange of purines; to increase the volume of urine, diuretics are used and antibiotic therapy is prescribed for concomitant inflammatory processes.
Diet for calculi
Adherence to the rules of a special dietary diet is the main measure in the therapy of urate formation, regardless of what treatment is prescribed by the doctor. The diet promotes the dissolution of urate formations. Food should be taken in fractional portions in the amount of 4-6 meals per day. It is imperative to include such foods in the diet:
- legumes;
- bakery products (especially from the highest wheat varieties);
- spinach;
- sorrel greens;
- luke;
- oatmeal;
- fish and seafood;
- spices;
- chocolate products;
- hot drinks (cocoa, tea, coffee);
- table salt.
Foods completely excluded from food:
- fatty meats and their offal;
- rich fish or meat broths;
- alcoholic drinks (beer, red wine).
AVISAN (Avisanum)
Contains the sum of substances obtained from the fruit of the Ammi Dental (Ammi Visnaga L.).
Pharmachologic effect. It has an antispasmodic (relieving spasms) property. By relaxing the musculature of the ureters, it promotes the advancement and discharge of ureteral stones.
Indications for use. Spasm (sharp narrowing of the lumen) of the ureters, renal colic.
Method of administration and dosage. Inside, 0.05-0.1 g 3-4 times a day after meals for 1-3 weeks.
To facilitate the removal of stones from the urinary tract, it is recommended to prescribe a large amount of fluid to the patient at the same time as taking Avisan. In the absence of contraindications from the outside of cardio-vascular system and the kidneys, the patient drinks 1.5-2 liters of water or tea within 2-3 hours. This technique is repeated after a few days. The patient should be under medical supervision.
Side effect. In some cases, dyspeptic symptoms (digestive disorders).
Release form. Coated tablets, 0.05 g in a package of 25 pieces.
Storage conditions. In a dry, dark place.
ALLOPURINOL (AUopurinolum)
Synonyms: Milurite, Apurin, Zilorik, Allopur, Atizuril, Foligan, Gothicur, Lizurin, Petrazin, Prinol, Piral, Purinol, Uridozide, Uriprim, Xanthurat.
Pharmachologic effect. By inhibiting xanthine oxidase, it inhibits the synthesis of uric acid, which helps to reduce the serum urate content and prevents its deposition in the kidneys.
Indications for use. For the treatment and prevention of diseases accompanied by hyperuricemia (increased content of uric acid in the blood) and the formation of urate stones (consisting of uric acid salts): primary and secondary gout, urolithiasis with the formation of calculi (stones) containing urates, primary and secondary hyperuricemia.
Method of administration and dosage. Inside after meals, 0.1 g 3-4 times a day, the daily dose can be increased to 0.8 g (in four divided doses).
In severe cases of gout, with significant deposits of urate in the tissues and high hyperuricemia (over 7 mg%), up to 0.6-0.8 g is prescribed in fractional amounts (no more than 0.2 g per dose) for 2-4 weeks, then switch to maintenance doses (0.1-0.3 g per day), which are given for a long time (over several months).
When you stop taking allopurinol, uricemia (increased uric acid in the blood) and uricosuria (increased excretion of uric acid in the urine) return to the initial level, so treatment should be prolonged. Gaps in taking the drug for more than 2-3 days are undesirable.
When treating with allopurinol, it is necessary to maintain diuresis (urination) at a level of at least 2 liters per day; it is desirable that the urine reaction is neutral.
Side effect. At the beginning of treatment, exacerbation of the disease, sometimes dyspeptic symptoms (digestive disorders), eosinophilia (an increase in the number of eosinophils in the blood), skin rashes, fever (a sharp increase in body temperature).
Contraindications. Renal failure with impaired excretory function, pregnancy.
Release form. Tablets of 0.1 g in a package of 50 pieces.
Storage conditions. List B. In the dark place.
BENZOBROMARON (Benzobromarone)
Synonyms: Normurat, Hipurik, Dezurik, Azabromaron, Exurat, Maksurik, Minurik, Urikonorm, Urikozurik, Urinorm.
Pharmachologic effect. Benzobromarone has a strong uricosuric effect (increases the excretion of uric acid). The effect is mainly due to inhibition of the absorption of uric acid in the proximal (located in the central part of the kidney) renal tubules and an increase in the excretion of uric acid by the kidneys. In addition, the drug inhibits (suppresses the activity) of enzymes involved in the synthesis of purines. Under the influence of benzobromarone, the excretion of uric acid through the intestines is enhanced.
Indications for use. It is used for hyperuricemia (increased content of uric acid in the blood) (with arthritis / joint inflammation / with hyperuricemia, hematological diseases, psoriasis, etc.) and gout.
Method of administration and dosage. Assign to adults orally during meals, starting with 0.05 g (50 mg \u003d "/ 2 tablets) 1 time per day, and with insufficient decrease in the content of urate in the blood - 1 tablet per day.
In acute attacks of gout, it is sometimes prescribed in short courses of 1/2 tablet 3 times a day for 3 days.
During treatment, to prevent the deposition of calculi (stones) in the urinary tract, the patient should drink at least 2 liters of fluid per day.
Side effect. The drug is usually well tolerated. In some cases, gastrointestinal disorders (diarrhea), skin allergic reactions are possible. With gout in the first days, joint pain may increase; in these cases, non-steroidal anti-inflammatory drugs are prescribed.
Contraindications. Pregnancy, breastfeeding, severe liver and kidney damage. Do not prescribe the drug to children.
Release form. Tablets of 0.1 g in a package of 30 pieces and tablets containing 0.08 g (80 mg) of micronized benzobromarone (hipurik).
Storage conditions. In a dark place.
Blemaren
Synonyms: K-Na hydrogen citrate, Soluran.
Pharmachologic effect. Contributes to the neutralization of urine, allows you to maintain the pH (acid-base state) in the range of 6.6-6.8, which creates optimal conditions for increasing the dissolution of uric acid. Long-term use of the drug leads to the dissolution of uric acid stones and prevents their appearance.
Indications for use. Urolithiasis with a predominance of urates, prevention of the formation of uric acid stones.
Method of administration and dosage. Doses are set individually, on average 3-6 g (1-2 dosed spoons) 2-3 times a day after meals. The drug is diluted in water or fruit juice. Treatment is carried out under the control of urine pH 3 times a day using an indicator attached to the drug.
Alkaline urine reactions (pH above 7.0) should be avoided as this promotes phosphate formation.
Side effect. Rarely - disorders of the gastrointestinal tract.
Contraindications. Chronic urinary tract infection with bacteria that break down urea
acute and chronic renal failure, circulatory failure.
Release form. In a package of 300 g with a dosed spoon, a control calendar and an indicator for determining pH. Composition per 100 g of granules: dehydrated citric acid - 39.90 g, potassium bicarbonate - 32.25 g, dehydrated sodium citrate - 27.85 g.
Storage conditions. In a well-sealed container in a dry place.
Knotweed BIRD GRASS (Herba Polygon! Avicularis)
Contains flavonol glycosides - quercetin, hyperoside, avicularin; tannins.
Pharmachologic effect. Anti-inflammatory and concrements (stones) discharge agent.
Indications for use. As an anti-inflammatory, concrement-promoting remedy for kidney and bladder stones.
Method of administration and dosage. Apply as an infusion (10.0: 20.0-15.0: 20.0), 2 tablespoons 3 times a day before meals.
During treatment, to prevent calculus deposits in the urinary tract, the patient must drink at least 2 liters of fluid per day.
Release form. In a package of 100 g.
Storage conditions. Store in a cool dry place.
MARENA DYE EXTRACT DRY (Extractum Rubiae tinctorum siccum)
Perennial rhizomes and roots extract herbaceous plants madder dye (Rubia tinctorum L.) and Georgian madder (Rubia iberica Fisch.), fam. madder (Rubicea). They contain at least 3% anthracene derivatives.
Pharmachologic effect. Has antispasmodic (relieves spasms) and diuretic effect; promotes loosening of urinary stones containing calcium and magnesium phosphates.
Indications for use. Urolithiasis disease.
Method of administration and dosage. Inside 0.25-0.75 g 2-3 times a day in 1/2 cup warm water... The course of treatment is 20-30 days.
Side effect. Paints urine reddish.
Release form. Tablets of 0.25 g in a package of 100 pieces.
Storage conditions. In a well-sealed container.
TABLETS "MARELIN" (Tabulettae "Marelinum" obductae)
Combined preparation containing dry madder extract, dry horsetail herb extract, dry goldenrod extract, monosodium magnesium phosphate, korglikon, kellin, salicylamide.
Pharmachologic effect. It has antispasmodic (relieves spasms) and anti-inflammatory effects. Promotes the discharge of renal calculi (stones), consisting of calcium oxalates and calcium phosphates. Reduces or relieves pain in renal colic. With an alkaline reaction, urine shifts the pH (an indicator of an acid-base state) to the acidic side.
Indications for use. Urolithiasis disease.
Method of administration and dosage. In the presence of calculi, take 2-4 tablets 3 times a day by mouth (before meals) daily for 20-30 days. Treatment is carried out by repeated courses with an interval of 1-1.5 months.
For the prevention of relapses (re-deposition of stones) after surgical removal of stones or their spontaneous discharge, 2 tablets are prescribed
3 times a day daily for 2-3 months. If necessary, the course of treatment is repeated after 4-6 months.
For patients with inflammatory diseases of the gastrointestinal tract, the drug is prescribed after meals (possible dyspeptic symptoms / indigestion / and exacerbation of peptic ulcer disease).
Contraindications. Acute and chronic glomerulonephritis (kidney disease).
Release form. Tablets containing: dry madder extract - 0.0325 g, dry field horsetail herb extract - 0.015 g, dry goldenrod extract - 0.025 g, single-dispersed magnesium phosphate - 0.01 g, corglikon - 0.000125 g, kellin - 0, 0025 g, salicylamide -0.035 g, coated, in glass jars of 120 pieces.
Storage conditions.
Cystenal
Pharmachologic effect. Spasmolytic (relieves spasms), anti-inflammatory and diuretic (diuretic) agent.
Indications for use. Urolithiasis disease.
Method of administration and dosage. Inside, half an hour before meals, 3-4 drops (with an attack of 20 drops) on a piece of sugar; with frequent attacks 10 drops, 3 times a day.
To facilitate the removal of stones from the urinary tract, it is recommended to increase the introduction of fluid into the body simultaneously with the drug intake. In the absence of contraindications from the cardiovascular system and kidneys, the patient should take at least 1.5-2 liters of liquid (alkaline mineral water, tea, fruit juices).
Contraindications. Glomerulonephritis (kidney disease), severe renal dysfunction, gastric ulcer.
Release form. In vials of 10 ml. Ingredients: tincture of madder root - 0.093 g, magnesium salicylate - 0.14 g, essential oils - 5.75 g, ethyl alcohol - 0.8 g, olive oil up to 10 ml.
Storage conditions. Under normal conditions.
MAGURLIT (Magurlit)
Pharmachologic effect. The drug is designed to shift the pH (acid-base state) of urine towards an alkaline reaction, as well as to inhibit the formation and dissolution of stones, consisting of calcium oxalate, as well as a mixture of uric acid with calcium oxalate.
Indications for use. Magurlite is used to dissolve and prevent the re-formation of urinary stones in cases with persistent acidity of urine (pH less than 5.5).
Method of administration and dosage. Is taken internally. The average dose for adults is 6-8 g per day (2 g in the early morning, 2 g in the afternoon, and 2 or 4 g in the late evening). Drink with water (or fruit juice).
To further clarify the dose, the urine pH is determined daily using an indicator paper attached to the preparation, comparing the staining with the applied color scale; The pH of fresh urine, determined in the morning, afternoon and evening before taking the drug, should be in the range from 6.0 to 6.7-7.0 at the correct dosage. Exceeding this value is necessary
avoid, as an alkaline urine reaction (pH above 7.0) can form phosphate stones. To maintain the pH at the indicated level, the dose of the drug must be selected individually.
To facilitate the removal of stones from the urinary tract, it is recommended to increase the introduction of fluid into the body simultaneously with the intake of magurlite. In the absence of contraindications from the cardiovascular system and kidneys, the patient should take at least 1.5-2 liters of liquid (alkaline mineral water, tea, fruit juices).
The drug can be used for a long time - continuously or intermittently.
Treatment should be carried out under medical supervision.
Side effect. In the course of treatment, disturbances in the activity of the gastrointestinal tract can be observed, usually passing without stopping the course of treatment.
Contraindications. Chronic urinary tract infections, circulatory failure (due to the large amount of sodium and potassium in the preparation).
Release form. In bags of 2 g of the drug in a package of 100 pieces with indicator papers, color scale and tweezers attached.
Storage conditions. In a well-packed container.
OLIMETIN (Olimetinum)
Synonyms: Enatin, Rovatin, Rovakhol.
Pharmachologic effect. It has a diuretic, anti-inflammatory, antispasmodic (relieves spasms), choleretic effect.
Indications for use. Kidney and cholelithiasis.
Method of administration and dosage. Inside before meals, 2 capsules 3-5 times a day. For prophylaxis (after stones have passed), 1 capsule per day for a long time.
Contraindications. Urinary disorders, acute and chronic glomerulonephritis (kidney disease), hepatitis, gastric ulcer.
Release form. Capsules of 0.5 g in a package of 12 pieces. The composition of one capsule: peppermint oil - 0.0085 g, purified turpentine oil - 0.01705 g, essential calamus oil - 0.0125 g, olive oil - 0.46025 g, purified sulfur - 0.0017 g.
Storage conditions. Store in a cool, dry place, protected from light.
PINABIN (Pinabinum)
50% solution of the heavy fraction of essential oils (from pine or spruce needles) in peach oil.
Pharmachologic effect. It has an antispasmodic (relieving spasms) effect on the muscles of the urinary tract, bacteriostatic (preventing the growth of bacteria) effect.
Indications for use. Kidney stone disease, renal colic.
Method of administration and dosage. Inside, 5 drops 3 times a day on sugar 15-20 minutes before meals. The course of treatment is 4-5 weeks; with renal colic, once up to 20 drops on sugar.
Side effect. Large doses of the drug can cause irritation of the mucous membrane of the stomach and intestines, hypotension (lowering blood pressure).
Contraindications. Nephritis, nephrosis (kidney disease).
Release form. In vials of 25 ml of a 50% solution in peach oil.
Storage conditions. List B. In a cool place.
SULFINPYRAZONE (Sulfmpyrazone)
Synonyms: Anturan, Anturanil, Anturidin, Enturan, Pirocard, Sulfazone, Sulfizone, etc.
Pharmachologic effect. It is an active uricosuric (excreting uric acid) agent.
Indications for use. Used to treat gout. Increases the excretion of uric acid through the kidneys, especially in the first stage of treatment.
Method of administration and dosage. Assign inside, usually in a daily dose of 0.3-0.4 g (in 2-4 doses). Take after meals; it is advisable to drink it with milk.
It should be borne in mind that small doses of salicylates weaken the uricosuric effect of sulfinpyrazone. The drug enhances the action of oral anticoagulants, oral antidiabetic agents, sulfonamides, penicillin.
Side effect. Usually sulfinpyrazone is well tolerated, but exacerbation of gastric ulcer and duodenal ulcer is possible.
At the beginning of treatment for gout, attacks may increase. When "prescribing a course of treatment, first of all, it is necessary to inject a sufficient amount of fluid into the body and make urine exfoliate (intake of sodium bicarbonate); with an acidic reaction of urine, calculi (stones) may fall out in the urinary tract.
Contraindications. Peptic ulcer of the stomach and duodenum, hypersensitivity to butadiene and related drugs, severe liver and kidney damage.
Release form. 0.1 g tablets.
Storage conditions. In a dark place.
URODAN (Urodanum)
Pharmachologic effect. The lithium salts and piperazine included in the preparation, in combination with uric acid, form readily soluble compounds and promote its excretion from the body.
Indications for use. Gout, urolithiasis, chronic polyarthritis (inflammation of several joints).
Method of administration and dosage. Inside before meals, a teaspoon in "/ 2 glasses of water 3-4 times a day. Apply for a long time (30-40 days). If necessary, repeat the course."
Release form. Granules 100 g each. Composition: piperazine - 2.5 g, hexamethylenetetramine - 8 g, sodium benzoate - 2.5 g, lithium benzoate - 2 g, disodium phosphate (anhydrous) - 10 g, sodium bicarbonate - 37.5 g, tartaric acid - 35.6 g, sugar - 1.9 g
Storage conditions. Regular.
UROLESAN (Urolesanum)
Pharmachologic effect. Combined herbal preparation. It has antiseptic (disinfecting) properties, increases diuresis (urination), acidifies urine, increases the excretion of urea and chlorides, enhances bile formation and bile secretion, improves hepatic blood flow.
Indications for use. Various shapes urolithiasis and gallstone disease, salt diathesis, acute and chronic pyelonephritis (kidney disease) and cholecystitis (inflammation of the gallbladder), cholangiohepatitis (combined inflammation of the liver and biliary
ducts) and dyskinesia (impaired mobility) of the biliary tract.
Method of administration and dosage. 8-10 drops on a lump of sugar under the tongue 3 times a day before meals. The course of treatment depends on the severity of the disease and lasts from 5 days to 1 month. With renal and hepatic colic, a single dose can be increased to 15-20 drops.
Side effect. Slight dizziness and nausea are possible. In this case, an abundant hot drink and rest are prescribed.
Release form. 15 ml orange glass dropper bottles. Composition per 100 g: fir oil - 8 g, peppermint oil - 2 g, castor oil - 11 g, alcoholic extract of wild carrot seeds - 23 g, alcoholic extract of hop cones - 32.995 g, alcoholic extract of oregano herb - 23 g , Trilon - B 0.005 g.
Storage conditions. In a dark place at a temperature not exceeding +20 ° C.
FITOLISIN (Phytolysinum)
A mixture of aqueous herbal extracts and essential oil, containing flavone derivatives, inositol, silicates, saponins, cineole, borneol, terpineol, camphene, etc. Contains plant extracts: parsley root, wheatgrass rhizomes, horsetail herb, birch leaves, knotweed herb, etc. ., as well as oils - mint, sage, pine, orange and vanillin.
Pharmachologic effect. It has a diuretic, anti-inflammatory, analgesic and bacteriostatic (preventing bacterial growth) effect, and also facilitates loosening and removal of urinary calculi (stones).
Indications for use. Inflammation of the urinary tract, kidneys, renal pelvis and bladder, loosening of urinary calculi and facilitating their excretion in the urine.
Method of administration and dosage. A teaspoon of paste is dissolved in / 2 cups of warm sweet water. Take 3-4 times a day after meals. Take a long time.
Contraindications. Acute inflammatory kidney disease, nephrosis (kidney disease), phosphate lithiasis (phosphate kidney stones).
Release form. Pasta in tubes of 100 g.
Storage conditions. In a cool place.
ETAMID (Aethamidum)
Synonyms: Etebenecid.
Pharmachologic effect. It inhibits the reabsorption (reabsorption) of uric acid in the renal tubules, promotes its excretion in the urine and reduces the content in the blood.
Indications for use. Chronic gout, polyarthritis (inflammation of several joints) with impaired purine metabolism, urolithiasis with the formation of urates.
Method of administration and dosage. Inside, after meals, 0.35 g 4 times a day for 10-12 days. After a 5-7-day break, treatment is continued for 7 days. If necessary, according to the doctor's prescription, the dose is increased.
Side effect. Possible dyspeptic and dysuric (digestive and urinary disorders) phenomena that pass on their own.
Release form. Tablets of 0.35 g in a package of 50 pieces.
Storage conditions. In a dry place.
Almost every second patient with a diagnosis of urolithiasis is faced with the situation when urate stones are formed in the kidneys.
The urate calculi are round in shape, have a smooth surface, and the color varies from yellow to brown.
The risk group includes people of the age category from 20 to 55 years. In elderly patients, urates are diagnosed in the bladder, and in young people - in the kidneys and ureter.
The danger of uric acid stones is the development of complications if a person does not seek qualified help for a long time.
Three factors can most often provoke the formation of urate kidney stones.
Formation of urate stones
1. High acidity of urine. In order to regularly measure the acidity level of urine, experts advise using test strips or a medical device - a hand-held pH meter at home.
This technique allows you to effectively control and make changes to the nutritional system and the course of therapy. Normal values \u200b\u200brange from 6.0-7.0 pH. During the day, the indicator changes from more acidic (up to 6.4 pH) to more alkaline (from 6.4 pH). If the level of urine acidity is above 5.5 pH, you need to pay attention to the diet. It is best to measure acidity twice: an hour before meals and a few hours after.
If urolithiasis is suspected, urine acidity should be measured twice a week, three times a day.
2. Uraturia - increased content of uric acid salts in urine. If an acidic urine reaction is recorded, this is not a sufficient reason for the formation of urates. Stones appear with a complex of factors: high acidity and the presence of uric acid salts. Salts of this category are present in the body of every person.
Formation of uric acid in urine
A favorable condition for their precipitation and the formation of urates is urine acidity below 5.0 pH. To change the reaction of urine from acidic to alkaline, it is enough to add a variety of dairy products to the diet. But the excess amount of meat dishes on the menu contributes to the formation of urates. That is why urate stones are diagnosed in men much more often than in women.
You can neutralize the effect of meat products with vegetables and herbs.
3. Low rate of urine formation. If urine in the body does not form quickly enough, its concentration exceeds the permissible norm, and this can provoke the formation of urates. In order to speed up the process of urination, you must drink plenty of water. However, it must be borne in mind that excessive fluid intake is contraindicated in patients with pathologies of the cardiovascular system.
Reasons for the increase in urate formation
Other factors contributing to the formation of urates:
- lack of vitamin B;
- a long course of treatment with analgesics;
- improper nutrition;
- sedentary lifestyle.
In severe cases, urates transform into dangerous coral-shaped stones, which in turn cause pyelonephritis and even kidney failure.
Symptoms of the disease
Urolithiasis, in spite of the chemical composition of calculi, takes a long time without pronounced symptoms. As a rule, the patient learns about the disease only when renal colic begins.
Blockage of the ureter with a stone - renal colic
- discomfort in the lumbar region, manifested on one side;
- discomfort spreads to the abdomen, bladder and genitals;
- pain cannot be eliminated medicines, a person cannot find a comfortable position to relieve pain;
- chills;
- nausea and vomiting;
- flatulence;
- high body temperature (appears with an inflammatory process in the kidneys).
Renal colic occurs when calculus prevents the flow of urine from the body.
Diagnosis of pathology
To identify urolithiasis and establish the chemical composition of calculi, a set of diagnostic measures is used:
- ultrasound examination of the kidneys;
- detailed analysis of urine and blood;
- urography;
- cT scan;
- magnetic resonance imaging;
- radiography of the kidneys using a contrast agent.
Standard X-ray examination does not provide an opportunity to detect urate stones.
Treatment
Considering the peculiarity of urates easily dissolve in water, as a rule, the treatment of urate kidney stones does not require procedures associated with penetration into the body.
Thus, it is possible to achieve complete dissolution of uric acid stones in the kidneys.
Also, a course of conservative therapy involves:
- taking medicinal decoctions of medicinal herbs with a diuretic effect;
- the appointment of a therapeutic diet based on dairy products, fresh vegetables and the complete absence of meat and offal;
- the drink must be alkaline.
Surely, many of you have heard of such a disease as gout. But not everyone is aware that it occurs due to deposits of uric acid in the joints. Pathogenesis of increased blood urate, risk factors and treatment.
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In this article, you will learn all about the causes of urolithiasis in women. Treatment and diet for urolithiasis.
Therapeutic diet for urates
Therapeutic diet for urate kidney stones is not just one of the stages of therapy, but a way of life. There are three categories of products: prohibited, conditionally allowed, and healthy.
Diet with uric acid stones
The basic principle for dividing food is the amount of animal protein in the food. The higher the protein level in a food, the more dangerous it is for a patient with kidney urate.
List of permitted food items:
- fresh vegetables, berries and fruits;
- milk products;
- cereals;
- pasta;
- coarse bread;
- vegetable, fruit and berry juices;
- compotes;
- weak tea with lemon.
List of foods that need to be limited
- bakery products made from wheat flour;
- legumes;
- spinach, sorrel and onions;
- a fish;
- chocolate;
- spices;
- spicy dishes;
- salt;
- strong tea.
List of Prohibited Foods
- alcoholic beverages;
- fatty meats;
- offal: kidneys, liver, heart, lungs;
- too saturated meat and fish broths;
- animal fat;
- canned and pickled foods;
- mushrooms.
In addition, you should drink at least two and a half liters of any liquid.
Treatment with folk methods
Herbs are widely used in the treatment of urate stones, which have a diuretic and anti-inflammatory effect on the body. For this purpose, you can prepare decoctions and infusions of lingonberry leaves, horsetail, bearberry and, of course, half-burnt.
The benefits of lingonberry for the kidneys
Very often, such herbal medicine contributes to the complete dissolution or removal of stones from the body.
Disease prevention
Treatment of urate calculi involves the observance of preventive measures aimed at eliminating the likelihood of re-formation of urate.
- Drink as much as possible. The recommended daily volume of fluid for an adult is often one and a half liters. However, this volume is only enough to maintain the natural metabolic processes in the body. When it comes to high-quality flushing of the kidneys, elimination of toxins and toxins, ensuring filtration, this amount of water is not enough. Drink at least two and a half liters of liquid.
- Avoid hypothermia of the kidneys.
- Avoid the development of infectious diseases.
- Constantly adhere to a therapeutic diet.
- Exercise regularly.
Only strict adherence to all preventive measures guarantees full recovery, and also significantly reduces the risk of urate calculi formation and possible complications in the future.
Video on the topic
The main cause of kidney stones - increased concentration of stone-forming salts in the urine. In turn, an increase in the concentration of salts in the urine may be a consequence of a long-term decrease in the daily volume of urine and / or excessive ingress of salts into the urine. Various reasons can cause decreased urine volume or an increase in the amount of salt in the body.
So, urine removes salts from the body, while the salts are in it in a dissolved state. With an increase in the concentration of salt in the urine, it can no longer completely dissolve and forms crystals. Over time, the crystals, connecting with each other, form calculi.
Note the fact that urine contains substances that prevent the formation of stones in the kidneys. These include magnesium, citrate, pyrophosphate, etc. What do these substances do? Firstly, they prevent the formation of crystals from salts, even though their concentration in urine is increased. Second, they can bind to crystals, preventing them from sticking to the urinary tract. A lack of these substances can also cause kidney stones.
Another reason for the formation of stones in the kidneys is change in urine acidity... For example, uric acid calculi appear faster in acidic urine, and calcium phosphate, on the contrary, in an alkaline environment.
Picture.The figure shows a primitive diagram showing the mechanism of stone formation. Both excessive ingestion of salts in the urine and a decrease in the volume of urine lead to the same thing, namely, an increase in the concentration of salts in the urine, their combination and precipitation.
inadequate fluid intake or vigorous exercise without adequate fluid replacement increases the risk of kidney stones. It is logically clear that hot climatic conditions can also predispose to the formation of calculi, since a hot dry climate contributes to dehydration due to increased sweating... Chronic impairment of the outflow of urine can be the cause of the formation of calculi in the kidneys. Kidney stones can also form due to urinary tract infections. Metabolic disorders, including congenital and acquired diseases, can lead to a change in the composition of urine towards an increase in concentration stone-forming salts.
Most often a person has four types of stones: calcium, urate, struvite (in other words, infectious) and cystine. Let's take a closer look at the reasons for the formation of certain types of kidney stones.
Picture.The figure shows stones located in the small and large cups of the kidney, the initial part of the ureter.
Calcium oxalate kidney stones are the most common type of calculus. Often, the cause of calcium stones is unknown. And this condition has the medical name of idiopathic nephrolithiasis. Most calculi appear as a result of dysregulation of calcium and oxalate metabolism. Moreover, in half of the cases, dysregulation is associated with genetic factors. Some of the causes of kidney stones are due to impaired digestion and the absorption of calcium and oxalate in the intestine.
Excessive calcium in the urine. This explains the formation of 70% of calcium stones. The following reasons can lead to an increase in urinary calcium:
- Too much calcium is absorbed in the intestines. Don't assume this could be due to your increased calcium intake. Often, the increased calcium absorption is due to genetic factors, although in most cases the exact cause is not clear.
- Leakage of calcium in the kidneys: In this case, there is a violation of the metabolism of minerals in the body, characterized by an excess of calcium in the urine.
- Some defects in kidney function can be accompanied by metabolic disorders, while there is an increased sodium content in the urine, which in turn leads to an increase in calcium levels. Also, excess consumption of table salt can lead to increased levels of sodium and calcium in the urine.
Increased urinary oxalate. Oxalates, like calcium, are the most common component of kidney stones. Too high urinary oxalate is associated with stone formation in 60% of cases.
What leads to increased urinary oxalate?
- An increased content of oxalate in urine can be a manifestation of congenital or genetic metabolic disorders.
- In addition, a number of pathological processes and diseases can lead to a secondary increase in the level of oxalates in the urine: a lack of vitamin B6 in the body, short bowel syndrome, which develops after the removal of a significant part of the intestine or as a result of inflammatory bowel diseases. In addition, a diet rich in oxalates may contribute to excess buildup in urine.
- Changes in hormone levels, in particular male sex hormones, can lead to impaired oxalate metabolism. An interesting fact is that the female sex hormones estrogens, on the contrary, reduce the risk of kidney stones. Estrogens prevent the development of calcium kidney stones by maintaining an alkaline urine reaction and high citrate levels.
Elevated blood calcium. Increased blood calcium can be caused by bone breakdown, accompanied by the release of large amounts of calcium into the bloodstream. This could be the result:
- Disease of the parathyroid glands, characterized by their increased work, causes 5% of all cases of kidney stones. People with this condition have a twenty percent risk of kidney stones. In women, diseases of the parathyroid glands are more common than in men.
- Prolonged immobility and immobilization, such as from trauma, can cause kidney stones.
- Renal tubular acidosis is a disease accompanied by a change in the acidity of urine. At the same time, the level of calcium in the urine increases and the concentration of citrate decreases.
Low level citrate in urine... Citrate is a substance responsible for the elimination of calcium from the body. In addition, citrate prevents calcium ions from forming crystals and the formation of calculi. Low urinary citrate levels are one of the causes of calcium kidney stones. Also, a lack of citrate can increase the risk of urate calculi formation.
What could be the reason for the decrease in the concentration of citrates in the blood?
- Renal tubular acidosis;
- Lack of potassium and magnesium in the body;
- Urinary tract infections;
- Renal failure;
- Chronic diarrhea, etc.
Also, a number of medications can increase the risk of kidney stones, for example, the antifungal drug amphotericin B, hormonal drugs, theophylline, vitamin D, etc.
Causes of uric acid kidney stones
Urate stones - These are calculi consisting of uric acid salts.
Where does uric acid come from in the body?
Purines are the source of uric acid formation in the body. Purines- these are vital and irreplaceable components of any cell in the body. They are a part of DNA, various enzymes, etc. A large amount of purines is found in protein foods, especially in protein of animal origin. When body tissues are destroyed or when protein foods are consumed, purines are released, which, under the action of a number of substances, are converted into uric acid. Normally, the human body contains a certain small amount uric acidbut too much can cause kidney stones.
A number of pathological conditions and diseases can cause the formation of urate calculi in the kidneys:
- Gout. Uric acid kidney stones form in 25% of patients with gout. Gout is characterized by high levels of uric acid in the blood and the deposition of salt crystals in one or more joints.
Picture. The picture shows the big toe joint lesion and kidney stones, which is a manifestation of gout.
- Diabetes. In people with type 2 diabetes, there is an increased content of uric acid salts in the urine, which is accompanied by the formation of calculi in the kidneys. Those. for the 18 million people around the world living with diabetes, the risk of urate formation is higher.
- Kidney anomalies. Kidney disease, characterized by a decrease in ammonium production, can cause calculi.
- Genetic Causes of Kidney Stones: Several genetic factors increase the risk of uric acid kidney stones.
- As we have already mentioned, a lack of citrate in the urine can be an indirect cause of uric acid stones.
- Excess consumption of foods rich in purines, namely animal proteins, is a common cause of kidney stones.
Less commonly, uric acid stones can be caused by:
- Taking certain medications (chemotherapy drugs, diuretics, salicylates, etc.).
- Alcohol abuse.
- Chronic diarrhea.
- Rare types of anemias (diseases involving the destruction of red blood cells) and treatment of tumor processes (lymphoma, myeloma or leukemia), accompanied by massive destruction of tumor cells. When cells are destroyed, purines are released into the blood, from which uric acid is formed. This may be the reason for the formation of urate calculi in the kidneys.
- Lead poisoning, etc.
Please note that increased uric acid content in the urine can trigger the formation of calcium stones. Therefore, often in patients with uric stones, calcium calculi can be found.
Struvite stones also called infectious calculi, as they are formed as a result of infections of the urinary system caused by bacteria that can secrete a special enzyme. This enzyme increases the ammonium content in urine. Ammonium, in turn, forms crystals and forms struvite calculi. Women have twice the risk of developing infectious stones than men.
Causes of Other Kidney Stones
Less commonly, people may have xanthine, cystine, medicinal and other stones.
For example, cystine stones are formed due to genetic abnormalities. The genetic defect causes a violation of the transport of the amino acid cystine in the body, leading to its accumulation in the urine and the formation of calculi in the kidneys.
Xanthine stones may result from long-term treatment of gout with allopurinol.
Uric acid stones are formations that are easiest to dissolve with the help of drug therapy. The uric acid salts of which they are composed are effectively dissolved with the help of litholytic therapy preparations.
X-ray examination is not able to diagnose urate stones due to their low density, but they are clearly distinguishable on ultrasound. It is possible to determine the composition of the formation by examining it after surgical removal or independent exit from the urinary tract. It is possible to determine the composition of the stone in the body using diagnostic methods. If the pH of the urine deviates from the norm towards acidity, it is most likely a urate stone. Determine the exact density of the formation using computed tomography.
But CT scan is not necessary if there are the following signs:
On ultrasound, the stone is visible;
On x-ray, urate stone is not detected;
Urine tests revealed a shift in pH towards acidic reaction.
If these signs coincide, it is worth trying to dissolve the stone. Most often, such formations occur in patients with impaired purine metabolism. For this reason, if urolithiasis is suspected, a study of the level of uric acid in the blood should be carried out.
Role of urine pH in dissolving urate stones
To dissolve urates, an alkaline drink is prescribed, which increases the level of acid-base balance. Citrate preparations are designed to convert urine from acidic to slightly acidic or alkaline. The dissolution of urate stones with the help of drug therapy takes from 2 months to six months.
To speed up this process, the following tactics are used - preliminary remote or contact endoscopic crushing of at least 2 cm in size, and subsequent dissolution of the remaining small fragments. Treatment is accompanied by plenty of drinking and adherence to a special diet.
Most often, patients seek medical help when the stone has moved from the place of its formation and moves from the kidney along the urinary tract. Movements are accompanied by acute pain due to renal colic, and the appearance of obstructive pyelonephritis. Since there is no time for a long process of dissolving a large stone, the stone is removed by any available method, and the remaining formations are then dissolved.
Dissolving urate stones with plain water
With an increased volume of fluid consumed, the pH of the urine shifts towards a decrease in acidity. As a result, the concentration of salts decreases and small urate formations dissolve. If the stone has a mixed composition, or a constant elevated level of urine pH cannot be maintained by the citrate preparations taken, then their further use does not make sense. If the treatment is successful, then citrate mixtures should be used further, but under the guidance of a urologist or nephrologist, since drugs for dissolving stones have pronounced side effects.
Note the important fact that alkalization of urine reliably dissolves only uric acid formations. Although it is possible to dissolve oxalate formations using citrate mixtures, in practice it is not so effective. As a rule, citrate preparations are taken for prophylaxis, after the crushing of calcium oxalate kidney stones.
Will lemon or cranberry juice dissolve urate stones?
No, these remedies are not capable of dissolving stones, lemon acid only minimizes the absorption of calcium in the gastrointestinal tract. Abuse of such recommendations can lead to stomach bleeding and other negative consequences up to.
Is it safe to drink diuretic herbs?
Uncontrolled intake of renal teas leads to dangerous consequences... The stone in the kidney, under their influence, can be moved at the most inopportune moment. As a result, an acute inflammatory process develops, the patient experiences acute pain in renal colic.
The patient is diagnosed with urolithiasis under the following conditions:
The size of the stone is more than 0.5 cm;
It has a dense structure;
Ultrasound does not pass through the stone (there is an acoustic path).
In medical practice, the diagnosis of "sand in the kidneys" is not made. What is taken for "grains of sand" on an ultrasound is the inlaid papillae of the kidneys, blood vessels, or compacted fiber. Do not drink diuretics at the first suspicion of "kidney sand". An ultrasound should be done once every 6 months, determining the dynamics of changes in the renal structure and extraneous formations in it. If there is no growth of stones, most likely these are individual features of the structure of the kidney.
Diet for urate kidney stones
Diet food - an important component of the treatment of urolithiasis. It is prescribed taking into account the general condition of the patient, the presence of somatic diseases. So, for example, with cardiovascular disorders, it is required to limit the amount of fluid entering the body. Diabetes patients should adjust the recommended diet to suit their needs.
It is necessary to maintain a balance of substances that the body needs for normal functioning, and not to apply the diet for a long time. Otherwise, stones of a different composition will begin to form.
The basic principles of a diet in the presence of urate stones:
Limitation of foods that provoke urolithiasis;
The use of products that affect the change in urine response;
An increase in the volume of fluid used to remove salt sediment.
For the therapeutic effect, products with a minimum of purines are recommended: bread, dishes from vegetables, fruits (with the exception of prohibited crops), dairy products, nuts, berries, cereals. Dishes from low-fat combs of meat and fish in boiled form are allowed, 1 egg per day, the use of butter or ghee.
Prohibited Products:
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Horseradish and mustard as a seasoning;
Sweet pastries;
Coffee, cocoa, hot chocolate;
Refractory fats: beef, lamb, culinary;
Canned food;
Salty and spicy cheeses;
Sausages.
Meat offal;
Legumes, peanuts;
Vegetables: cauliflower, sorrel, spinach;
Fruits: raspberries, figs, cranberries;
With the patient's recovery, the diet is gradually adjusted, returning to the usual level.
Education: Diploma in the specialty "Andrology" was obtained after completing an internship at the Department of Endoscopic Urology of the Russian Medical Academy of Postgraduate Education at the urological center of the Central Clinical Hospital No. 1 of JSC Russian Railways (2007). Postgraduate studies were completed here by 2010.
