Kinds of stones - urate stones in the kidneys
The presence of certain concrements is a characteristic sign of urolithiasis. And the average urate stones in the kidneys occupy a leading position in the frequency of occurrence. They are second only to oxalate stones. Not surprisingly, the kidneys are one of the main organs for the metabolism of uric acid and urea.
Characteristics of urolithiasis
Urolithiasis is a pathological condition of the urinary system, in which there is a disturbance of one or another metabolism. In this case, stones and similar insoluble compounds are formed. In the latter case we are talking about "sand".
This is important! The importance of the problem of urolithiasis is indicated by the data of statistical observations in different regions of the globe. The average age of patients with this pathology is in the range of 20 to 50 years. That is the most able-bodied years.
The main reasons for the development of urolithiasis include a number of external and internal factors.
- Internal factors. Diseases of the kidneys and urinary tract.
- Pathologies of the gastrointestinal tract.
- Endocrine diseases.
- Exchange disorders in the body. A classic example is gout - a disorder of impaired exchange of purine bases.
- Severe injuries with a prolonged period of immobilization.
- Hereditary predisposition.
- Environmental factors.
- Systematic eating disorders with the abuse of certain types of food and liquids.
- Poor water quality: increased stiffness and significant shifts in its acid-base balance to the other side.
- Harmful and difficult working conditions.
The main signs of urolithiasis are pain and dysuric phenomena. This is a violation of urination or the presence of blood impurities( hematuria).Pain is localized in the projection of the kidneys or ureters. Everything depends on the location of the stone. In the presence of bladder stones, pain is projected onto the hypogastric region and so on. The pain is episodic. That is, they are impermanent and mainly associated with the beginning of the movement of the stone. Resting concrement to certain sizes of unpleasant sensations does not give.
Even stones of considerable size, which, after their formation, remained in one place nothing but a sense of gravity and, raspiraya with the corresponding side, do not give. And as the concrements often develop, not simultaneously the general urination is not disturbed even with the defeat of one kidney by giant stones.
Types of stones processes and formations
All concrements of the urinary system are divided into three groups. Acidic, alkaline and conditionally neutral.
Sour stones. These are urate and oxalate concretions. The former are formed from salt uric acid. The latter are the products of oxalic acid. Their labeling is associated with insoluble compounds of these substances. Normally, these compounds are found quite often. But due to the presence of close to neutral urine, their "precipitation" is impossible. Even when phages at certain times become acidic their formation is impossible due to the presence of urodynamics. Therefore, the main reasons for their formation are the following( and necessarily a simultaneous combination of the two).
- Acid medium of urine.
- Excessive content of uric acid and oxalate.
- Reduction of the main indicators of urodynamics.
Alkali stones on the contrary, - formed with an alkaline environment of urine. They include phosphate and carbonate stones. Their formation is associated with the presence of at least two of the three main factors.
- Alkaline environment.
- Excess content of phosphates and carboxylic acid residues.
- Deceleration of the processes of urination.
All the other types of stones are considered conditionally neutral stones. They are much less common than the two previous groups. For their formation, the leading role is played by a decrease in the rate of formation and retention of urine. Most often, these concretions are the results of the formation of complex compounds of amino acids, metals and components of the bacterial wall.
Uranium Stones: Key Features of
The main feature of urate stones in the kidneys is the presence of residues of uric acid and their form. These stones have a smooth surface and, very often, have a rounded shape. This leads to the fact that urate stones are very often mobile, which leads to the development of spontaneous attacks of renal colic. In addition, they can often go out on their own.
Externally the calculi are similar to dirty white spherical bodies. They are quite dense, but light. Dimensions rarely exceed a few millimeters.
Uric acid is incapable of forming strong enough joints. The fact is that the bonds in the stones are only covalent and hydrogen bonds. There are no ionic compounds. Therefore, their strength depends strongly on the acidity of the medium.
Treatment of urate stones
These characteristics allowed to develop effective treatment of urate stones in the kidneys. They depend mainly on the size of the stones and their location.
Both conservative treatment methods and surgical intervention are used. However, the latter with urate stones are used much less often than in the case of concrements of other species.
- Conservative treatment includes a number of measures aimed at eliminating( removing) stones and preventing their re-education. This includes both medicamentous and non-medicinal methods.
- Drug treatment involves taking drugs aimed at the main links of the pathogenesis of urolithiasis. Diuretics contribute to increasing the rate of formation and retention of urine. Anti-inflammatory drugs are prescribed if there is a phenomenon of aseptic inflammation. If it is caused by microorganisms, antimicrobials may be needed.
- Non-drug treatment is also largely directed to the main links of pathogenesis. They also contribute to the dissolution of stones. They are based on a specific diet. The predominantly sour-milk products are used, abundant alkalizing drink. The fact is that this greatly increases the acidity of urine. And as you know, the strength of the compound of molecules in urate stones depends on the environment. As a result, an increase in its acidity to 7 and higher leads to the rupture of covalent bonds due to which the dissolution of urate stones occurs.
- Surgical treatment is indicated in case of significant stone size and danger of complete obstruction( lumen overlap) of the ureter. The most commonly used is remote lithotripsy. In its pure form, it can not be called an operative intervention, since there is no incision of the skin.
And all the impact makes directional ultrasound. But since the technique is carried out by urologists, related to the surgical specialty, lithotripsy was not considered an invasive surgical method. Finally, in urgent situations, it may be a direct surgery to extract stones.
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