According to statistics, from 5 to 15% of people suffer from the formation of urate stones in the kidneys. Often, kidney stone disease is asymptomatic up to its most severe manifestation - renal colic. This is an emergency condition requiring urgent hospitalization, and in order to prevent it, it is important to know the causes of the formation of urate stones, as well as the features of treatment and prevention of dangerous pathology.
How do urate stones form
Potassium urate and sodium urate are acidic salts of uric acid, which are formed as a result of metabolic processes, are part of the urine and do not cause harm in a small concentration.
When the amount of urate increases, the filtering ability of the kidneys decreases, while the uric acid salts crystallize and precipitate. The formation of calculi begins - dense formations, which are called uric acid or urate stones. If deposits are found in the renal pelvis and calyces, the patient is diagnosed with kidney stone disease (nephrolithiasis). If the pathological process has affected the entire urinary system, the diagnosis of urolithiasis (urolithiasis) is made.
Even once having seen how the urate stones in the kidneys look (pictured), it is unlikely that a person will want to carry this dangerous ballast in the body.
These are rounded, from above smooth deposits ranging in size from 1 - 2 mm to several cm, usually yellowish-brown in color. The structure of uric acid stones is quite loose, due to which they can be dissolved and removed from the body without surgical intervention.
Urate Deposition: Risk Factors
The main reason for the formation of urate stones in the kidneys is the acidic reaction of the urine: if pH <5.5, there is a chance of a decrease in urine output and deposition of salt sediment.
The main factors contributing to the acidification of urine and provoking the development of kidney stone disease:
- living in regions with a dry, hot climate, where there is a high risk of frequent dehydration;
- the presence in drinking water of a high concentration of hardness salts (Ca, Mg);
- lack of fluid intake;
- physical inactivity (sedentary or sedentary lifestyle);
- malnutrition, for example, excessive consumption of animal protein or exhausting starvation;
- violation of calcium metabolism.
The risk group includes people with a hereditary predisposition to the formation of urate stones in the kidneys. They are advised to periodically check the urine reaction using a special device - a pH meter or visual uri-pH test strips. Normally, there should be an alkaline reaction (6.0 - 7.0). If the indicator does not fall below 5.5 units for a long time, and the lifestyle remains the same, the person is actually insured against the formation of uric acid stones.
Options for the development of kidney stone disease
The danger of the disease lies in its asymptomatic course. In the best case, pathology is detected, for example, during a physical examination, this usually occurs at the initial stage of calculus formation. In the presence of urate stones in the kidneys, their dissolution and diet completely eliminate the progression of the disease and possible serious consequences.
Another case: insignificant deposits can form, collapse and wash themselves if the acidity of the urine is compensated by a large amount of drinking water (at least 1.5 liters per day) and a healthy diet.
When the processes of stone formation in the kidneys disrupt the production of urine, and large deposits prevent its outflow, the symptoms of the pathology appear suddenly and in the most cruel way.
Renal colic and other symptoms of deposition of uric acid stones
Obturation, or, more simply, obstruction of the urinary tract is impossible not to feel. Look at how large urate kidney stones look in the photo, and imagine that one of them overlaps the left or right ureter.
Full or partial obstruction increases urine pressure and stretching the walls of a hollow tubular organ, and then the kidneys.
A person experiences sudden unbearable pain in the lower back, usually right or left, in rare cases of herpes zoster. When trying to change the position of the body, stand up or lie down no changes occur. Pain arises from the back and gives to the lower abdomen and groin - these are characteristic signs of renal colic. At the same time, it is impossible to stop the pain, conventional analgesics do not help.
Other symptoms may be associated with increasing pain:
- bloating;
- intense gas formation;
- increased sweating;
- nausea, vomiting;
- chills and fever.
The last symptom may indicate the development of inflammation in the tissues of the kidney, but in any case, the overall clinical picture is not in doubt: the patient needs emergency medical care.
If the size of the stone allows it to pass through the ureter without damaging the wall, the attack passes on its own. However, similar symptoms are observed with an ectopic pregnancy, rupture of the ovary or pancreatitis, so it is very important to consult a specialist who can conduct differential diagnosis in a timely manner.
Risk of complications
Like any pathological process, the formation of urate stones progresses, and over time, the calculus grows throughout the renal pelvis with processes in each calyx. A more serious disease develops - coral nephrolithiasis, when a sparing dissolution method no longer helps, and nephrolithotripsy is required to treat the pathology, and in especially severe cases, removal of the affected kidney.
Ureteric deposits often provoke inflammation of the renal tubules (pyelonephritis), as well as the development of acute or chronic renal failure.
Against the background of a high concentration of uric acid, salts are deposited in the joints and a dangerous metabolic disease, gout, develops.
Do not wait until the body acquires a whole bunch of complications, modern diagnostic methods allow you to detect uric acid deposits at the very beginning of their formation.
Diagnosis of urate
Sometimes ultrasound is enough to detect uric acid calculi, the results of which determine how urate stones in the kidney look: their localization, shape and size. Ultrasound is always used in emergency cases when there is no time to conduct a comprehensive examination.
In advanced conditions, as well as in the presence of concomitant diseases of internal organs, additional diagnostic measures are required:
- excretory urography:
- a study using radiopaque substances that allows you to objectively assess the condition of the kidney and ureters;
- MRI and CT of the kidneys: highly informative research methods that are usually prescribed for differential diagnosis;
- extended urine and blood tests to confirm the nature of calculi.
According to the results of the diagnosis, the nephrologist prescribes adequate treatment for urate stones in the kidneys: drug therapy aimed at dissolving calculi, crushing with ultrasound or surgical intervention.
Dissolution of uric acid stones: a conservative method for the treatment of kidney stone disease
Due to the porous structure, urate calculi respond well to dissolution. However, the process of removing stones from the body does not always proceed painlessly, in addition, during the examination, the patient may reveal concomitant urinary tract infections.
Therefore, in most cases, the doctor prescribes complex therapy using several drugs:
- stone dissolution: "Blemaren", "Urolesan", "Solimok", "Kanefron";
- expansion of the urinary tract: "Spazmalgon", "No-shpa", "Papaverine";
- elimination of infectious and inflammatory processes: Amoxiclav, Nitroxoline, Klaforan;
- removal of a pain syndrome: "Revalgin", "Ketorol", "Baralgin".
To prevent the formation of new deposits, it is important to convert the urine reaction from acidic to alkaline. For this, the patient is advised to drink more fluids, including alkaline mineral waters, for example, Borjomi or Kislovodsk Narzan. And of course, a diet with urate stones in the kidneys is an important condition for complete recovery and prevention of the deposition of uric acid salts.
Clinical nutrition for kidney stones
A proper diet will not only cleanse the kidneys from pathological deposits, but also prevent their reappearance. The following foods should be the basis of nutrition:
- vegetables, preferably cucumbers, tomatoes, pumpkin, carrots, beets;
- fruits with a diuretic effect - apples, mangoes, dried apricots (dried apricots);
- berries - watermelon, cranberries, lingonberries;
- cereals - millet, buckwheat, oatmeal;
- nuts and seeds;
- milk, dairy products and drinks;
- coarse flour pasta and bakery products.
It is better to exclude fish, fatty meat and any meat broths during treatment. Of course, you should refrain from smoked meats, pickles and alcohol, reduce the use of tea, coffee and chocolate.
In the presence of urate stones in the kidneys, their dissolution with drugs and diet gives excellent results, however, adhering to the basic rules of prevention, you can avoid relapse.
Prevention of the formation of uric acid stones
Observing drinking regimen, you will avoid problems associated with acidification of urine. For an adult, 1.5 liters of pure filtered water is enough per day, in hot weather the norm increases to 2.5 liters. It is important to note that this applies to people who do not have serious disorders of cardiovascular activity, a tendency to form edema and diagnosed renal failure.
As a prophylaxis, they periodically drink a course of herbal infusions that prevent stone formation, for example:
- juniper;
- lingonberry leaf;
- licorice root and wheatgrass;
- highlander bird (knotweed);
- horsetail.
Urate kidney stones are not a sentence, therefore it is not necessary to adhere to a strict diet, but it is important not to abuse alcohol, salty and fatty foods.
Please note: all of the above recommendations relate to the prevention and treatment of kidney stone disease and are equally effective for urate stones in the bladder (urolithiasis). However, self-medication is unacceptable. The appointment of drugs and herbal medicine should be handled by a qualified specialist - a nephrologist.