Kidney stones (Nephrolithiasis)
It is a term applied to accumulation of deposits in the urinary tract due to a complex interplay of factors which eventually result in stone formation. Complaints arise due to obstruction caused by these deposits.
The stones may form anywhere in the urinary tract and accordingly may be called renal (Kidney) calculi, ureteric (ureters) calculi or vesical (urinary bladder) calculi.
What causes renal calculi?
Analysis of normal urine composition demonstrates the presence of organic components along with mineral salts in a unique proportion so the function of elimination is effectively carried out. The human body has a vast capacity to adjust and readjust the biochemical reactions according to varying metabolic demands. Whenever the kidneys reflect an increased concentration of solutes as also an inability to keep them in suspension, they precipitate and predispose to the formation of stones.
Factors which favour formation of stones are,
- Inadequate water intake which brings about precipitation of salts
- High protein intake
- High sodium intake
- Increased levels of calcium in the blood as seen in hyperparathyroidism, thyrotoxicosis, elevated Vitamin D3 levels
- Increased excretion of calcium in the kidneys
- Increased oxalate and urate elimination.
What are the symptoms of renal calculi?
The symptoms vary according to the site and size of the calculi. At times there may be no symptoms altogether and the calculi may be seen as an accidental finding during abdominal radiography.
The most common features are,
Pain, often severe in nature is especially experienced as the calculi moves in the ureters. The pain is colicky and felt in the flanks or may radiate from the back to the front of the abdomen in the groins along the course of the ureter. The pain may be excruciating and requires urgent medical attention.Pain, often severe in nature is especially experienced as the calculi moves in the ureters. The pain is colicky and felt in the flanks or may radiate from the back to the front of the abdomen in the groins along the course of the ureter. The pain may be excruciating and requires urgent medical attention.
There may or may not be haematuria that is frank blood in urine.
The patient is very uneasy and restless and there may be vomiting.
Increased frequency of urination and pain while passing urine is a common feature.
These attacks may occur intermittently or the patient may complain of continuous dull pain in the back.
Passage of sand in urine. Recurrent urinary tract infections.
What are the types of calculi?
Depending upon the chief constituent of the stones there are
- Calcium oxalate stones, the most common variety and one which is irregular in outline, easily visible on X-ray and causing bleeding due to its sharp points
- Phosphate calculus which is smooth and tends to take the shape of the renal pelvis giving rise to staghorn calculi
- Uric acid calculi are due to increased uric acid levels or gout and they are multiple in number
- Cysteine calculi are due to increased excretion of the amino acid cysteine.
What investigations need to be done?
A routine urine examination with the clinical history is usually enough to diagnose renal calculi.
A plain X-ray abdomen demonstrated the opacities.
An IVU (intravenous urogram) may be done as per the requirement.
What precautions need to be taken to prevent formation/recurrence of calculi?
- Maintain a high water intake at all times.
- Avoid excessive intake of food rich in calcium.
- Restrict intake of sodium and proteins.
What is the role of Homoeopathy in renal calculi?
Homoeopathy aids in expulsion of calculi which can pass through the ureters.
It also prevents recurrence of formation of stones.
It works effectively towards relieving the pain and discomfort of the patient in acute episodes of renal colic.
It has also been known to reduce the size of the calculi thereby aiding dissolution and expulsion.
It prevents and resolves infections of the urinary tract.