Renal Lithiasis
What are the causes and symptoms of kidney stones? Everything about kidney calculi and the different types of lithiasis.
Symptoms and Causes
Lithiasis is a condition that leads to the formation of calculi or stones in the urinary system. When the stones form in the kidney, it is called nephrolithiasis, whereas if they are found in any other part of the urinary system, such as the ureters, bladder, or urethra, it is referred to as urolithiasis.
Although stones do not usually cause long-term damage, their passage can be extremely painful. Depending on their composition and location, surgery may be required to remove them, or they may be left to pass naturally.
Some studies suggest that individuals who have experienced lithiasis have a high probability of suffering another episode in the following years. Therefore, it is considered a chronic disease associated with genetics, diet, lifestyle, or certain digestive, renal, or endocrine disorders.
Symptoms
The symptoms of lithiasis vary depending on the size of the stones, their composition, and their location. However, the most common symptoms in most patients include:
- Renal colic: Pain of varying intensity that originates in the lower back and radiates through the abdomen, groin, or genitals. It is usually caused by the pressure exerted by accumulated urine that cannot exit the body.
- Hematuria: Presence of blood in the urine, typically caused by the erosion of blood vessels due to the stones.
- Urinary tract infections.
- When the pain is severe, it may be accompanied by vomiting, fever, or sweating.
Causes
The primary cause of lithiasis is urine with an excess of crystallizable substances. Depending on the main component of the stones that form, lithiasis is classified into four types, each originating from different causes:
- Calcium stones: The most common type, usually caused by excess vitamin D, metabolic disorders, certain medications, calcium-rich foods, or as a consequence of gastric bypass surgery.
- Uric acid stones: Typically develop in individuals with a genetic predisposition, absorption disorders, or metabolic imbalances, those who consume excessive amounts of protein, or those who have recently experienced significant fluid loss.
- Struvite stones: Caused by urinary tract infections.
- Cystine stones: Result from an inherited genetic disorder called cystinuria, which causes the kidneys to produce excessive amounts of the amino acid cystine, which plays a role in the healthy development of hair, nails, and skin.
Risk Factors
Although lithiasis can occur in anyone, some factors increase the likelihood of developing the condition, including:
- Genetic predisposition.
- Environmental factors.
- Dietary factors, such as low fluid intake or excessive consumption of protein, salt, calcium, or sugar.
- Being between 40 and 50 years old.
- Being male.
- Having undergone gastric bypass surgery, suffering from cystinuria, having a parathyroid hormone imbalance, or experiencing recurrent urinary tract infections.
- Having previously had kidney stones.
Complications
The main complication of lithiasis is damage to the urinary tract. If sores or scars develop, they can lead to future obstructions or loss of kidney function.
Prevention
Lithiasis cannot be completely prevented. However, adopting certain habits can help reduce the risk:
- Drinking between 2.5 and 3 liters of fluids per day.
- Increasing fluid intake on hot days or during physical activity.
- Reducing the consumption of salt, calcium, and protein.
- Consuming more plant-based proteins than animal proteins.
- Maintaining a balanced diet.
- Exercising regularly.
Which Doctor Treats Lithiasis?
Urologists diagnose and treat lithiasis.
Diagnosis
To diagnose lithiasis, doctors typically use the following tests:
- Clinical symptom evaluation.
- Urine test: Detects excess minerals.
- Blood test: Provides an overview of kidney function.
- CT scan, ultrasound, or abdominal X-ray: Helps determine the location of the stones.
- Stone analysis: Identifies the components of the calculi to establish a tailored prevention plan for each patient.
Treatment
Depending on the location of the stone and the time elapsed since the first symptoms appeared, different treatments may be used for lithiasis:
- In most cases, the stones pass spontaneously through urination within three to four weeks. Drinking water and moderate rest are usually recommended.
- Ureteroscopy: An endoscopic procedure in which a flexible catheter is inserted through the ureter to remove the stone.
- Extracorporeal lithotripsy: Shock waves are used to break up the stones, facilitating their elimination through urine.
