kidney stones

Urolithiasis (Renal lithiasis)

It is the formation of stones in the kidney.

Their migration into the ureter is responsible for intense acute pain

They develops from an abnormal buildup of mineral crystals on the inner surface of the kidney. Urinary stones are generally classified according to their location in the kidneys (renal lithiasis), ureter (ureterolithiasis).

They are also classified by their chemical composition (containing calcium, struvite, uric acid, or other compounds). About 85% of kidney is made of calcium.

Kidney stones are more often seen in middle-aged and older adults and in men. They are of variable size, the smallest cannot be observed with the naked eye and the largest having a diameter greater than 2.5 centimetres.

A large calculus called a coralliform calculus (because it has many branches that make it look like deer antlers) can fill almost all of the renal pelvis (the central collecting cavity of the kidney) and the tubes that collect them. drain (chalices).

What are the causes of kidney stones?
- Citrate is one of those inhibitors that, under normal conditions, binds to calcium, itself often involved in the formation of stones.
- Calcifications are more common in people with hyperparathyroidism, and in those whose diet is very rich in animal protein or vitamin C or who do not drink enough water or do not consume enough calcium.
- People with a family history of stone formation are more likely to have calcium stones and suffer from them more often.
-People who have undergone weight loss surgery (bariatric surgery) may also have an increased risk of stone formation.
What are the symptoms of a kidney stone?
Kidney stones, especially small ones, can be asymptomatic.

The stones that obstruct the ureters, the pelvis or one of the drainage ducts of the kidney can cause intense pain. Renal colic is characterized by unsustainable and intermittent pain, usually in the area between the ribs and the hip, which radiates to the abdomen and often extends to the genital area.

The pain tends to occur in waves, gradually increasing to a maximum intensity and then decreasing for a period of about 20 to 60 minutes. The pain can go down in the abdomen towards the groin, the testicles or the vulva.

Renal colic may be accompanied by nausea and vomiting, agitation, sweating and the presence of blood in the urine (hematuria) or the expulsion of a calculus or calculation fragment in the urine.

People may feel an urge to urinate frequently, especially when passing calculus into the ureter.
How to make the diagnosis of a kidney stone?
- A urine test can detect the presence of blood or pus in the urine, regardless of the presence of symptoms.
- An uroscan can locate a calculus and also indicate how much the calculus obstructs the urinary tract.
- Ultrasound is an alternative to CT and does not expose people to radiation. However, it often cannot detect small stones, especially in the ureter.
- An X-ray of the abdomen is much less accurate for diagnosing stones. It can only highlight calcium stones.
What is the treatment of kidney stones?
- Symptomatic stones are mainly treated.
- It is necessary to take nonsteroidal anti-inflammatory drugs or opioids to relieve pain.
- By making the urine more alkaline (for example, by potassium citrate is taken orally for 4 to 6 months), only uric acid stones are sometimes gradually dissolved.
- Small stones that do not cause symptoms, urinary tract obstruction or infection usually do not require treatment and are often expelled spontaneously.
- Larger stones (more than 5 millimetres) and those close to the kidneys are less likely to be expelled spontaneously.
- Some drugs (tamsulosin or calcium channel blockers) may increase the possibility of spontaneous elimination of stones.
- Shockwave lithotripsy can be used to break up a calculation in the pelvis or upper part of the ureter with a diameter of 1 centimetre or less. In this procedure, shock waves directed to the body by a sound wave generator fragment the calculation. The fragments of the calculation are then eliminated in the urine.

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Dr. Marois is a urologist who is not a member of the Régie d’Assurance Maladie du Québec (RAMQ). As such, the clinic can not claim the RAMQ for the payment of his services. If you consult Dr Marois, you must pay for the services rendered.

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