Kidney stones (renal lithiasis):
Renal calculi is formation of stone in any part of the urinary tract. urinary tract is divided into four main divisions
- Kidney (renal calculi)
- Ureter (ureteric calculi)
- Urinary bladder(vesical calculi)
Cause of renal calculi depends one many factors,of which the following are important
- Concentrated urine especially in hot climate,decreased fluid intake,chronic diarrhea.
- Urinary stasis-urinary tract obstruction,prolonged recumbency.
- Recurrent urinary tract infections
- Polycystic kidney disease
- Vitamin A deficiency
- Foreign body
- Hypercalcaemia-hyperparathyroidism,vitamin D deficiency,excessive calcium intake eg milk,cheese,eggs.
- Hyperoxaluria-excessive intake oxalate eg tomato,raddish,spinach,strawberry,tea,chocolate,cold drinks.
- Hyperuricemia-gout,excessive purine rich food intake eg red meat,fish.
- Common in males and common or peak incidence 30-50 years.
Clinically, calculi is divided into
- Renal calculus
- Ureteric calculus
- Vesical calculus.
In renal calculus symptoms are pain in flank,dull aching,pain worse on movement,changing position,walking upstairs,haematuria.
In ureteric calculus symptoms are pain which has sudden onset ,sharp,excruciating pain,which radiates tofrom loin to groin,patient draws up his knees and rolls,vomiting,strangury,haematuria.
In vesical calculus,symptoms are frequent unsatisfactory urination,pain at the end of micturation which is worse during exertion,jolting movements;better by lying. interruption of urinary stream(stone blocking internal meatus) better by change of posture,haematuria.
Plenty of fluid intake,diet restriction according to the type of stone,
If stone is uric acid and urates,eliminate-meat and meat products,dals,whole grain cereals,oat,meal,dried peas and beans.
If stone is oxalate eliminate-spinach,sweet potato,almonds,cashewnuts,grapes.
Large stones need to be removed surgically.