Kidney Stones
KIDNEY STONES
United States every 1000 patients hospitalized with kidney stones because of the stay is in l’. In 1% of autopsy cases made stones are often found. Accordingly, a more general approach of kidney stones and urinary tract stones is a large part silent. That is disturbing the patient does not reveal any symptoms. According to the chemical structure, can be found in different kidney stones. Chemical structure “Calcium oxalate”, “calcium phosphate”, “Amon-yumürat”, “Sodium urate”, “Uric acid”, “Cystine”, “xanthine”, “Calcium carbonate”, “Ammonium phosphate” and “Magnesium phosphate” The stones are. Calcium phosphate, calcium carbonate, ammonium phosphate, magnesium phosphate, calcium oxalate stones, kidney x-rays taken to see in a simple possible.
Other stones can be seen “intravenous piyelografi” [1VP] called in a special way, the withdrawal of X-ray of the kidneys is required. 80% of cases of kidney stones are formed in one side. More frequent in the right kidney stone is composed. Two times more frequently in men than women are to be found for the kidney stones. In 60% cases kidney stones are one. Kidney stone 0.5 cm of 5 cm in size until in olabilmektedir.İdrar urate, phosphate, oxalate, such as the molten state is crystalloid-ier. Normally the urinary tract will be wet with urine. But that will develop a urinary tract infection, you wet from the urine of lead.
In the urine that can be abnormally wet surfaces so that the stones begin to eat crystalloid to collapse. Urea, nitrogen, can be found in the urine certain substances such as salicylic acid, “Hidrotrop item-ler” dir. These substances will increase their crystalloid dissolubility in urine, so the stone to create this prevents the collapse of crystalloid. In urine “nucleic acid”, “Chondroitin sulfuric acid” has such colloids. It consists of kidney stones in the absence kolloidle-rin. Urine than normal density in the interior of the crystalloid or the person’s water loss due to heavy urination, kidney stones prepared for the user is a factor. Phosphate stones occur when the urine is alkaline, acid urine and urate stones in the kidney did occur in the fog. Cause of kidney stone cases 4′üniin% of the “Gut” is a disease. Taylor is 5% of cases of familial tendency is detected.
Vitamin A deficiency, urinary tract caused by the narrowness of the slow flow of urine, to be bedridden for a long time, chronic inflammation of bone, hyperparathyroidism, vitamin D excess leads to the formation of kidney stones are the various factors. Kidney stones usually occur in the kidney calices. Outward flow of urine with kidney stone thrown into the road, it can block the urethra and from any region. As a result, urine can accumulate behind the blockage. Kidney and urinary tract infections also occur in this case, the way ACAB-knows. Stones, urinary tract bleeding within the movement, while the vast majority of the road açabilir.Kidney stones will not bother the patient. Beürti is given the most important symptoms “pain” and “hematuria” dir. Pain, kidney stones and urinary tract as a result of progress in the developing urinary tract spasm is optional. Such as pain may be blunt, “colic” called very severe, the occidental features may also be a pain, Koük pain is very severe, the patient is convulsed, solar face, sweat is pouring. The pain may spread to the entire abdomen. Nausea and vomiting may develop pain as a result. Moving blood in the urine and urinary tract may occur as a result of the damage [hematuria).
Kidney stones are caused by pain during attacks, patients and spasms of pain relievers morphine or similar drugs given solvent, is useful in terms of pain relief. Patient to drink more water, urine flow will increase, moving from falling easier. May be dangerous for patients with non fell spontaneously and surgical methods of kidney stones and must be removed. From meat and liquid from the rich, the very poor from the carbohydrate diet and ‘to walk up to one hour per day, or regular sports yapmaki against kidney stones önleyicidir.Böbrek precious stones in the ordinary conditions of dissolved substances in the urine sediments of the hard particles deposits occur. Of these substances led to the formation of kidney stones başlıcalan tirade, such as oxalate and calcium phosphate compounds.
Symptoms of the disease process depends moved instead may occur. Kidney stones in the dish (calyx) or pool (pelvis) can be placed. Also siyek (urethra), urinary bladder and urethra also (ureter) may. The number of kidney stones, and their locations are classified according to chemical structure. Small number and they are small round, as bladder taşlannda many and rubbing each other if they are cornered. Such as a kidney dish and pool to be large spaces they create shows. The very small size of the ones who get all the grit size to fill the gap kidney changes.
CAUSES
Kidney stones, depending on the sometimes develop a metabolic disorder, and sometimes hereditary revealed. Moving to occur because of the urine to increase the intensity or dissolved substances in the urine excessive amounts of bulunmasıdır.Taş led to the formation of metabolic disease, renal source for the rebel-dose (acidity level rise), for hereditary diseases in sistinüri (such as sis did the amino acids in the urine excessive increase) as an example be given. But the 70-percent of kidney stone cases a definite cause can not be shown in up to 80. Stone formation and generally hereditary links to some other determinant factors. Between them in the urine crystallization tendency of the food finding, the urine flow of a barrier because stops; urine were acid (pH) of the level change, yollanrıın bladder inflammation, such as sediment will form material meets the physical and chemical environment, the preparation of the environment in the sediments to facilitate a self-forming bacteria, the cell residues such substances cause stone formation in the presence of a single per sayılabilir.Kendi primary hyperparathyroidism disease. (parathyroid gland wear work-masi). Increased calcium levels in the blood and urine to form calcium phosphate stones prepares appropriate environment. The percent of all kidney stones are calcium stones creates 50-80.
The most common calcium oxalate kidney stone is composed of the grayish-red color. This white calcium phosphate and calcium urate stones are yellowish-brown marks. Gut (drop) id-like illness with a high degree rarlannın acid uric acid taşlanna quite common brown ones (5-33 percent by region) are found. The greenish fog between you and görülenlerler rare tawny stone KSAN-tin pool consisting sayılabilir.Böbrek stone, it is not very large, goes to the bladder through the urethra. Here urination difficult, such as prostate growth conditions occurred, or become even larger in the urine is excreted from the bladder. On the other hand from kidney stones in the kidney to the bladder or the urethra in the pool in the mouth can get stuck. In this case, congestion may occur and sometimes the kidneys.
SEE being INTERVAL
Kidney stone at least three times higher in men than in women is common. Mostly between the ages of 30-50 is seen.Hastalığın irregular geographical distribution. Egypt, China, Russia, Wales, Madagascar, USA and Turkey’s southeast sector from a kidney stone is being quite common olgulanna southern India, in the northern part of China, Ireland and South America, cases of kidney stones are almost never seen. This distribution in the formation of the disease, nutrition, climatic and geological factors is important as the theory does not support the full.
EVIDENCE
Kidney stone symptoms may not be long or extremely close to trivial causes. With different pain intensity started to appear in the urine of kidney sand transport is considered. Basic symptoms of the disease “in renal colic” pain is typically called. It started suddenly with severe seizures AGN, in the stone wall of the urinary tube in the form of spasm or contraction-man pool of kidney stone blocked stress suddenly started causing severe seizures AGN. Initially, the interval, then the continuity of the first waist region often feel pain is. Here spread throughout the urinary tract anus around AGN, and the cane at the beginning of testes in men, large lips in women, as well as the groin, inner thighs and sometimes the chest and shoulder blades in six can be seen. During the most severe pain that restlessness, anxiety, cold sweat, back muscle contractions in, nausea and vomiting occur. If lowering the stone patients, Tasmin narrow siyek (urethra) passes through the channel created by AGN is extremely severe. Taylor immediately after lowering and appeared comfortable with patients of all symptoms will disappear.
The amount of urine during the AGN significantly less and is bloody. Kidney or bladder moved to return to the pool reduces symptoms other than the best hafifler.Belde lead to a slight feeling of fullness without the large kidney stones may be. The reason for this paradoxical situation in a region of the kidney taşlann big move is that it is not stuck in the format. In these patients, definitive diagnosis is not always easy.
REVIEWS
Nowadays, diagnostic examination methods are sufficient to lead to. The important thing is to take necessary measures without ağnlı period. Basic diagnostic method is one of the radiological examination. 80 percent of the stones Hastalann calcium salt (phosphate, oxalate, carbonate) occurs. Calcium stones through X-rays to determine not easily captured in film. Undergoing X-rays do urate, xanthine, and mag-ammonium phosphate stones nezyum-contrast agent for detecting urinary yollanna must be granted. This is an application of indirect methods to pass rapidly from the blood to the kidneys of the contrast agent is given intravenous. X-ray contrast agent is blocking the urinary tract through the visible state, while kidney stones are located in areas it can not fill the contrast agent remains. This method has two name: intravenously (through veins) to view urography name given to the veins auxiliaries, “in which urography called out to the contrast material in the blood can be caused by kidney. Is unable to provide sufficient information Ürografinin in clinical symptoms and laboratory data of kidney stones think “the ürografiye” to apply. In this method, urinary tract contrast material directly to the vessel instead of to give siyek inserted a tube (catheter) is used.
Abdominal ultrasound, X-ray beam passes through, whether or not allow a diameter of up to half a centimeter the exact location of even small stones set format is a way-yebilen. But with this method of urine and urinary tract stones carried in the pipe caused changes or structural properties can not be determined who created the stone formation. No harm to the patient and ease of application ultrasonography because a method is particularly useful in the diagnosis belirtisizDolguların. Laboratory studies is of crucial importance in the diagnosis of the disease. Searching in the urine of blood, urine, determination of the degree of acid in the blood to measure levels of calcium and uric acid analysis for diagnosis are of value. Chemical analysis and for the treatment of stones in the urine culture is very important.
Radiographic examination of the contrast agent is not used directly in the stone of doubt inspiring spots, can be traced in detail by urography. With this method, moved location, its effect on the function of the kidney and urinary tract not understood, more detailed information regarding the function of the kidney stone-free is obtained.
COMPLICATIONS
Complications arising from kidney stones and urinary tubes, namely, attachment disorders are common due to stone. Large stones, causing urine to accumulate kidney pool and a dish to expand their (hidronefroz), micro With the start time of nephritis (pyelonephritis), then the kidney tissue as a result of the abscess to destruction (piyonefroz) causes. Despite these complications, showing a slow growth, chronic pyelonephritis is inevitable that resulted renal
TREATMENT
Kidney stone treatment is done in three stages: pain therapy; stone or lead to the formation of ground preparation for the treatment of common conditions, disrupts the functions of the kidney and / or permanent surgical treatment of painful stone. Begin implementation of severe pain in the form of contractions or spasms of hot solvent, is an effort to relieve inflammation and pain relieving drugs.
NEW METHODS IN THE TREATMENT OF KIDNEY STONE
The newly developed methods in the surgical treatment of kidney stones in the urinary tract and led to great advances. In Sweden and especially Germany and the UK further developed methods of surgical treatment according to traditional methods of percutaneous lithotripsy ADH important advantage is carrying. Drop from a hole in the skin on the receipt of kidney stones, this method enables the user of the device simpler, faster and more cost application, the result is extremely positive because widely used in many countries has started. Moreover, the traditional treatment of painful postoperative period and remain in hospital for a long time, such as the unwanted result of this new method aşılmıştır.Perkütan lithotripsy method, first inserted through the skin with a device called the nefroskop kidney stones can be reached space be seen are provided. Gems do not exceed half a centimeter in diameter if the device is pulled out with forceps. Larger stones with a pump after sound absorbing dalgalanya parts. This method can be applied using local or general anesthesia. Patients starting from the first day of attempts to stand up and can eat.
Entry into the skin instead of pasting a tape to prevent any other, this method does not leave patients discharged from hospital 3-4 days after edilir.Böbrek taşımn another stone therapy outside the body of the ultrasonic waves generated by supersonic whether crushing is taken from the urinary tract. This method is also used in the treatment of gallstones. Ultrasound treatment to the patient and expert breaking stone with difficult situations of reduced complications, in addition also requires litotripsinin. First, lithotripsy, and then break the stone with ultrasound because of many reasons to take advantage of hard stone even more appropriate görülmektedir.En by entering through the skin can be applied to parts in the same way. The following stones kidney stones by breaking-of the treatment occurs in certain forms. These two methods can be applied with the patient while under anesthesia. Removal of kidney stones for the size of all the initiatives failed to move, shape, hardness, and instead, also narrowing of the urinary tract, Edema, and depends on features such as curvature.
SURGICAL
Surgical treatment is applied as a very limited today. Owing to more kidney stone lithotripsy and ultrasound can not be applied to the stone crushing method is used in patients. The other hand, stone crushing method, the excretory system remaining after surgery, infection, and causing new deposits is very useful stones removed. After the operation the remaining stones with shock waves “cleaning” of all stones with surgery to remove the requirement to be eliminated, otherwise largely has solved the problems arising.
PROTECTION
All types of stone to create a schedule from the feed is a common situation. The percentage of patients with calcium stone recurrence is seen within a year 20-30th. Therefore, all patients böbHc move must be made more incelemeerin. Thus, the primary hiperpara-tiroidizm, kidney source acidosis, was sis-specific diseases such as Nuri and infection depending on the evolving medical and surgical treatment of kidney stones should identify cases should be conducted accordingly.
Ultrasonography in the diagnosis of kidney stone patients is not harmful, such as diagnostic methods can also be used for other purposes. In some cases, kidney stones, requiring intensive treatment of a severe general disease symptom olabilir.Kidney first move on the one hand, loss of time, doctor and drug costs, ultrasound and surgical treatment of patients, such as expenditures to the economic and social burden, while on the one hand the unbearable pain and infections have will have a period. . Ultrasound treatment a few times to break the stone implement long-term results of kidney function is not known how well have been affected. But more than 70 percent of patients with kidney stones in the research section to a specific dysfunction has been found. Increase in calcium and uric acid excretion, urinary bladder disorders, such as increased acidity of laboratory investigations can be revealed.
In the light of information obtained in laboratory studies for the treatment of metabolic disorders may apply. Inhibitory effect of this treatment the formation of kidney stones, but that proved exactly yet.
There are two important points to note:
1) of the patients in more than 60 percent of patients with kidney stone formation be prevented by taking plenty of fluids: urine in 24 hours to remove at least 3-4 Push 1,5-2 lt liquid to be taken is very useful in the prevention of kidney stones. The restriction of fluid intake was heart failure, high blood pressure, this method can not be applied in such cases. In addition, calcium, oxalate-rich foods should be avoided and pürince. Slow as a result of the development of kidney stones do have a chronic disease. Patients remain under the supervision of the doctor constantly useful. In cases of unknown cause kidney stones emerging high calcium levels in the urine diuretic (diuretics) can be controlled with the help of medicines. This application together with reducing salt intake of sodium blocker treatment effect is resolved. Elevated levels of uric acid and oxalate in the urine of patients given 24 hours to 300 mg allo-purinol are quite useful.
