Urolithiasis is not uncommon at present. One of the varieties of pathology are oxalates in the kidneys. They are diagnosed quite often and pose 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 conservative treatment methods. In most cases, surgery is indicated when confirming the diagnosis.
The mechanism of the development of the disease
The epithelial tissue of the organs of the urinary system normally has a peculiar barrier, due to which the formation and accumulation of salts does not occur. Under the influence of various adverse factors, the protective function is disrupted. As a result, a number of chemical reactions are launched, the result 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 in them. Over time, crystals grow and become nuclei of oxalates.
The stones can be of various sizes - from 1-2 mm to 4-5 cm in diameter. In kidneys, oxalate stones are usually brown and black. A dark shade indicates that the mucous membrane of the organ has already been damaged by stones. Light brown stones are less common, 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 kidney cavity, emergency surgical intervention is indicated.
Reasons for education
The development of pathology occurs under the influence of both external and internal factors. The most common causes of oxalate kidney stones are the following diseases and conditions:
- hereditary predisposition;
- violation in the body of oxalic acid metabolism;
- lack of magnesium;
- inflammatory processes in the organs of the urinary system;
- gastrointestinal surgery;
- diabetes;
- unbalanced nutrition;
- Crohn's disease;
- deficiency of vitamins C and B 6 ;
- prolonged exposure to stress.
In addition, the composition of soil and water in the region of permanent residence affects the development of pathology. In some areas, residents receive minerals in excess of normal amounts.
Symptoms
The severity of signs of the presence of oxalate stones in the kidneys directly depends on the size of the stones. If they are only in the formative stage, a person may experience the following symptoms:
- Pain in the side. By the nature of the manifestation, it is dull and weakly expressed.
- Urine discoloration. Urine acquires a rich yellowish red hue. Urine also becomes cloudy.
Over time, oxalate kidney stones grow. The process is accompanied by the appearance of pronounced symptoms. At this stage, the patient has the following signs of pathology:
- Hematuria This is a condition characterized by the presence of blood impurities in the urine. Liquid connective tissue enters urine due to injury by spikes of calculi of the inner shell of the organ.
- Pain in the side. They are very pronounced, gradually increase and may result in an attack of renal colic.
- Frequent episodes of relapse of existing pyelonephritis.
- General malaise.
- Strong feeling of tiredness.
- Frequent urination.
Often, intensification of pain and the appearance of blood in urine occur after physical exertion, long walks, jogging or traveling on vehicles on rough roads (which is accompanied by shaking and, accordingly, displacement of calculi).
Diagnostics
Information on how to remove oxalate stones from the kidneys is provided by a nephrologist. It is to him that you need to contact at the first alarming symptoms. During the initial appointment, the doctor will collect an anamnesis and examine the patient, after which he will draw up directions for laboratory and instrumental studies.
Clinically significant for the disease is a general urine test. Specialists are 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 excreted through the kidneys with urine.
- Microhematuria. It is characterized by the presence of blood impurities in urine. In this case, liquid connective tissue in the urine cannot be seen with the naked eye.
- Mild proteinuria. In this condition, together with urine, a protein leaves the body, the amount of which exceeds normal values.
- The presence in the urine of glycolate and glyoxylic acid.
- An increased degree of crystallization ability in urine.
- Mild tubular dysfunction.
- The presence of markers indicating instability of cell membranes.
Urinalysis is the most affordable type of study, which allows not only to confirm the diagnosis, but also to determine the chemical composition of the stones.
Instrumental methods for diagnosing pathology include the following:
- radiography of the kidneys;
- back sowing of urine;
- Ultrasound
- scanning of the urinary system;
- contrasting techniques;
- chromocystoscopy;
- urography.
The advisability of prescribing certain studies is determined by the doctor. They are necessary in order to reveal the exact localization of stones, their quantity, size and shape. Based on the diagnostic results, the most effective treatment regimen is compiled. In addition, the issue of the advisability of surgical intervention is being addressed.
Drug treatment
Oxalate kidney stones are extremely difficult to treat. The prescription of medications is justified only if the size of the stones is small and there are no complications.
A treatment regimen for a pathology involves taking funds that have the following actions:
- Pain medication, especially when episodes of renal colic occur.
- Anti-inflammatory.
- Improving the outflow of urine.
- Contributing to the natural release of calculi from the body.
- Litholithic.
Most often, nephrologists prescribe the following drugs:
- "No-shpa" (antispasmodic).
- "Baralgin" (analgesic).
- "Blemaren" (a drug designed to detect oxalate kidney stones and dissolve them).
- Containing vitamins E and A (normalize the metabolic rate).
- "Fitolizin" or "Cyston" (contribute to the excretion of uric acid from the body).
- Containing vitamin B 6 (stops the growth of oxalates).
- "Asparkam" (compensates for the deficiency of magnesium and potassium in the body).
In addition, for the treatment of pathology, the use of special mineral waters is prescribed. They contain only those components that can improve the course of the disease. Doctors recommend the following items of mineral water for oxalate kidney stones:
- Essentuki No. 4.
- "Obukhovskaya".
- "Narzan."
In addition, this physiotherapeutic method can be used as a preventive measure for the occurrence of a disease or its relapse.
If taking medications for oxalate kidney stones has not led to a positive result, the doctor will decide on the advisability of an operation to remove calculi.
Surgical intervention
Currently, there are several methods for getting rid of stones:
- Traditional (open).
- Shock wave lithotripsy.
- Endoscopic.
Traditional surgical intervention involves the removal of calculi from the kidneys with direct access to the organ obtained due to a violation of the integrity of the skin. Surgeons resort to this method only in emergency cases, preferring more gentle methods.
Indications for an open operation are the following conditions:
- very large oxalates;
- acute pyelonephritis;
- relapse of urolithiasis.
The essence of the method is as follows: the patient is anesthetized, then the surgeon dissects the skin, fat layer and muscle tissue with a scalpel. After this, the kidney is cut and stones removed. The final step is the stitching of tissues and the installation of 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 open surgery is the rapid elimination of stones and, accordingly, painful symptoms for the patient.
A more modern method is shock wave lithotripsy. This is a method involving crushing kidney stones with ultrasound. Using the technique, it is possible to get rid of only small stones.
Shock-wave lithotripsy is performed as follows: a device is installed next to the patient’s body, which is designed to store kinetic energy. Stones decay into the smallest particles under the force of ultrasound directed directly 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 usual activities.
Crushing kidney stones by ultrasound is not performed in individuals with a history of: coagulation disorders of fluid connective tissue, a tendency to develop bleeding, pathology of the digestive system, malignant neoplasms, and serious diseases of the cardiovascular system.
There are several methods for endoscopic removal of calculi:
- Percutaneous nephrolithotomy.
- Urethroscopy
The first option is indicated for persons with kidney stones with a size of 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 introduced, creating a channel through which oxalates are crushed and removed.
Urethroscopy is used if the size of the stones 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 the tool, the doctor gets the opportunity to crush the stones into tiny particles, which can subsequently come out naturally.
The main disadvantage of this method is the need for the patient to be anesthetized. In addition, during the operation, the integrity of the body tissues is violated.
Alternative methods of treatment
It is important to understand that non-traditional methods do not relieve the patient from the need to seek qualified medical help. The main goals of alternative treatment are: to improve the condition of oxalate kidney stones, 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, and therefore folk methods can only be used to alleviate the symptoms of the disease or to get rid of fine sand that did not have 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.
- It helps to relieve symptoms of oxalate stones in the kidneys of grass. It is necessary to regularly take decoctions from the following medicinal plants: nettle, bearberry, peppermint, black elderberry, buds and birch leaves. The tool can be either single or multi-component.
Before using any methods of alternative medicine, it is necessary to consult with your doctor. Only he can give an unambiguous answer as to what can be used with oxalate kidney stones and what cannot.
Power Features
During the treatment of pathology, it is especially important to take nutritional adjustment. With oxalate kidney stones, a diet can significantly improve the patient's condition and prevent the formation of new calculi.
The following products must be present in the diet:
- boiled meat (chicken, turkey, lean pork, beef);
- milk (with an increased level of calcium in the urine is prohibited);
- oil of both vegetable and animal origin;
- bran bread;
- cereals (buckwheat, pearl barley);
- dried fruits compote;
- pasta;
- vegetables (preference is given to pumpkin, potatoes and cucumbers);
- fruits;
- nuts.
In the case of oxalate kidney stones, in no case should you include: offal, fish, salted cheese, smoked and spicy dishes, canned food, meat broths, coffee, jam, cocoa, mushrooms, chocolate, baking, some berries and fruits (strawberries, pear, blueberries and gooseberries).
Prevention
To prevent recurrence of the disease, it is necessary to drink as much as possible (up to 3 liters) of pure still water. To activate the process of removing sand, it is recommended to regularly perform simple physical exercises. In addition, it is necessary to adhere to the diet shown for oxalate kidney stones. Compliance with these rules significantly reduces the risk of calculus formation.
Finally
Oxalate kidney stones are dense formations with an uneven surface. They are formed under the influence of various adverse factors. Calculi of this type are extremely difficult to treat with conservative methods. With the ineffectiveness of medications, surgical intervention is indicated.