Summary
Nephrolithiasis is a condition where there is a build-up of insoluble deposits (stones or sand) in the kidneys or in the bladder. The movement of these stones, especially through the urethra, causes very severe pain called renal colic.
It is estimated that urolithiasis affects about 10% of adults. In this group, the ratio of men to women is 2-3: 1. Depending on the cause of the formation and the material from which the stones are made, we distinguish the following types of kidney stones: cystine, phosphate (struvite), oxalate (calcium oxalate), and gout.
In the prevention of urolithiasis, the most important thing is to properly hydrate the body (about 2.5?3.0 liters per day) and to limit the use of salt. It is also recommended to avoid eating excess meat, offal, herring, sardines, chocolate, cocoa, legumes and soups cooked on meat and bone stocks, spices with monosodium glutamate, rhubarb, spinach. The diet of a patient with urolithiasis should contain citrus fruits, fruit juices, milk, lean cheese and honey and whole grains and vegetables (cucumbers, onions, corn).
Nephrolithiasis is a condition where insoluble deposits (stones or sand) are build-up in the kidneys or in the bladder. The movement of these stones, especially through the urethra, causes very severe pain called renal colic. Its intensity is comparable only with the pain of labor and pain during a heart attack. It is estimated that urolithiasis affects about 10% of adults. In this group, the ratio of men to women is 2-3: 1.
Nephrolithiasis is a disease that has plagued people since antiquity.
The first mention of methods of treating kidney stones comes from ancient Egypt and dates back to 1550 BC.
In ancient Greece, the removal of urinary stones was already dealt with, which was described in “Diseases of the kidneys and bladder” by Rufus of Ephesus. In Rome, this disease was described by Aulus Cornelius Cestius in his encyclopedia De Medicina. Hippocrates, one of the precursors of modern medicine, wrote about doctors of a new specialty – lithotomists. They dealt with the removal of stones from the bladder.
It was recommended to use decoctions of plants such as chamomile, mint, bay leaf, dandelion. They helped to alleviate the course and symptoms of kidney stones.
In the Middle Ages, stones were removed by barbers and charlatans who had neither the appropriate knowledge nor qualifications.
The prognosis was very poor, the patient had to face either a slow death from rupture of the bladder or kidney failure as a result of urinary outflow obstruction by enlarged stones or, a little faster, due to complications following an operation performed using very brutal methods, without following basic hygiene rules. In both of these cases, death took place in great torment.
The case of a Dutch blacksmith, Jan de Doot, who, in extreme desperation, cut himself a stone from his bladder alive and, importantly, survived this operation, entered the history of medicine. It entered not only the history of medicine, but also the history of art, because it was portrayed, together with the excavated stone and the kitchen knife which performed this operation, by the painter Carel van Savoyen,. The painting can now be viewed in the Gallery of the University of Leiden.
Carel van Savoyen – Portrait of Jan de Doot, (around 1650)
(Wikipedia)
As surgery progressed, removing kidney stones became safer, but it was still highly invasive.
It was not until 1976 that a new method of percutaneous nephrolithiasis surgery appeared, consisting in puncturing the kidney, extending the puncture canal and inserting a nephroscope into it, with the help of which the stone was crushed and fragments removed.
Another progress limiting the invasiveness of this procedure was the introduction of a method that consisted in crushing stones by using shock waves released outside the patient’s body (lipotripsy). This procedure was performed for the first time in 1980.
The causes of kidney stones formation
Urinary stones can arise both from compounds that are naturally occurring in the urine and from pathological ones. The kidneys filter unnecessary substances from the blood and remove them from the body along with the urine. In some cases, some sediment remains at the bottom of the renal calyx. A sediment plate is formed. If it crushes itself, it will be expelled through the urinary tract into the bladder and then through the urethra to the outside. If it remains, it will become a center of crystallization that will gradually increase.
It happens when the concentration of stone-forming compounds is higher than the threshold of their solubility in the body.
The reason for this may be genetic predispositions, defects in the structure of the urinary system, urinary tract infections, the use of certain medications, some diseases of the digestive system, long-term use of alkalizing drugs, too little fluid intake, dehydration, overdose of vitamins D3, C and calcium, inappropriate, containing too much a lot of meat, diet. Depending on the cause of the formation and the material from which the stones are made, we distinguish the following types of kidney stones: cystine, phosphate (struvite), oxalate (calcium oxalate), and gout.
Prevention of urolithiasis and its recurrence
The basis is proper hydration of the body (about 2.5?3.0 liters per day) and limiting the use of table salt. It is also important to maintain a healthy body weight through an appropriate dose of physical activity adapted to the patient’s health, age and abilities. A beneficial effect is obtained by reducing the alkalization of urine.
Positive effects on the urinary tract are exerted by fenugreek seeds, knotweed herb, couch grass rhizome, horsetail herb, lovage root, onion husks, goldenrod herb.
It is recommended to avoid products containing purines, which are the raw material for the production of uric acid by the body, i.e. offal, herring, sardines, chocolate, cocoa, legumes and soups cooked on meat and bone broths.
In patients with oxalate stones, canned meat and fish, pickled products, spice mixes with monosodium glutamate, rhubarb, spinach, and chocolate should be excluded from the menu.
In the case of calcium phosphate stones, acidifying products are recommended: meat, cold cuts, bread, fish, pasta and groats (buckwheat, barley, pearl barley). In turn, you should avoid sources of calcium and phosphorus, which include, among others: milk and dairy products, eggs, legume seeds, spinach, sorrel, alkaline mineral waters.
Patients are advised to increase their consumption of magnesium-rich vegetables. On the other hand, you should give up milk, meat and its products, legume seeds, cereal products and offal.
In general, the food of a patient with urolithiasis should not be complete without citrus fruits, fruit juices, milk, lean cheese or honey, whole grains and vegetables (cucumbers, onions, corn).
AUTHOR: Dr n. farm. Andrzej Tarasiuk