Urolithiasis can exist in various forms. One of them is microlithiasis, a condition that must be treated in order to avoid a transition to more serious stages.
Microliths in the kidney - what is it?
A healthy person regularly drops salts into urine: if you do not empty the bladder on time( for example, at night), this process takes place in the body. When the amount of such salts is minimal, the condition is not considered pathology, but with an increase in sediment volume, a diagnosis is made-microlithiasis.
Microlits are a conglomerate of precipitated salts that are present in the urine in large quantities. Most often they appear in the right kidney, but can be present in both the left and in both kidneys at once. These small stones are able to stagnate in the kidneys themselves, and can move to the ureters and bladder. The disease is considered the initial form of urolithiasis and has the code N-20 "Stones of the kidney and ureter" in the ICD-10.
In addition to urates, such microliths can be present in humans:
- Oxalates are salts of oxalic acid.
- Phosphates are salts of phosphoric acid.
Initially, the patient has uric acid diathesis, or sand in the kidneys, which begins to crystallize as time progresses - microliths are formed. Anxiety at an early stage and without exacerbation of microlithiasis does not cause, but eventually, without treatment, concrements become larger, nephrolithiasis develops. In general, the pathology progresses for a long period of time, so with regular preventive examinations it will be revealed at the initial stage.
On the video about what microliths in the kidneys are:
Reasons for
There is no single and decisive cause that would influence the formation of microliths in the kidneys. This pathology is multifactorial, and its development depends on the mass of the negative factors affecting the organism.
The main ones are:
- Failures of acid-base composition of urine and metabolic disorders.
- Chronic inflammatory process in the kidneys.
- Anomalies in the structure of the urinary system and kidney operations that leave scars, scars, nephrostomy.
Single microliths appear in the renal pelvis and collecting tubes. It is there that crystallization of salts begins - particles of salts of various acids are collected. Further, microliths are formed, and their structure is divided into two parts - organic( only 3% of the total mass) and mineral. It is on the organic basis( the remnants of the epithelium, the products of the vital activity of bacteria) that mineral salts adhere.
Risk factors that increase the risk of formation of microliths in the kidneys are:
- Chronic pathologies of the gastrointestinal tract, liver.
- Osteoporosis.
- Diseases of the parathyroid.
- Consumption of poor quality water, low liquid intake.
- Frequent inclusion in the menu of salts, marinades, smoked products.
- Living in a hot climate.
- Certain soil composition, poor ecology.
- Syndromes of impaired absorption of substances in the intestine.
- Hypodynamia.
- Blood clots in the kidney vessels.
In a child, microliths most often appear not in the kidneys, but in the bladder.
The causes of the disease are:
- Inflammation in the kidneys, bladder, ureters with relapses.
- Anomalies in the structure of organs.
- Weighed down with heredity.
- Features of metabolism.
- Some hormonal diseases.
- A diet rich in purines.
Symptoms of
Many people have microlithiasis without any symptoms at all. Microscopic stones can be accidentally detected on a routine ultrasound. However, in other people, especially in the long course of the disease, concrements irritate surrounding tissues.
The signs of microliths in the kidneys are as follows:
- Blunt, aching, pulling pains in the area of the kidneys and lower back.
- Sensations in the spine, reminiscent of those with osteochondrosis( stiffness, burning, sometimes pain pricks).
- Increased discomfort in running, long walking, jumping.
- Increased urge to urinate.
- Burning in the urethra with urination.
Muddy urine is another sign of the appearance of sand in the kidneys, which is often noticeable with the naked eye. In addition, a true sign of the development of microlithiasis is renal colic. It arises from the injuries caused by sharp corners of the stones surrounding the soft tissues, and also because of the movement of microliths from the renal pelvis to the ureter. It is enough to leave a stone 3-4 mm in size, so that the signs of renal colic make themselves felt. Colic is due to the fact that microlites are very mobile and loosely sit in the pelvis, therefore, can move freely through the urinary system.
The clinical picture of the exit of the microlith is as follows:
- Severe pain in the projection of the kidney, sometimes difficult to bear by a person;
- Irradiation of pain in the groin, lower abdomen;
- Appearance of blood in the urine;
- Nausea, vomiting;
- Stool retention;
- Frequent false urge to go to the toilet;
- Increased body temperature;
- Weakness, tachycardia;
- Chills;
- Dry mouth;
- Bloating;
- Swelling of the feet.
In childhood, microliths in the kidneys are often detected. Suspected the existence of the disease can be due to weakness, frequent complaints of aching pain in the lower back, rapid urination in small portions. Renal colic in a child is less common than in adults, but with their development, the symptoms are similar to those described above and strongly resemble pain in appendicitis.
Diagnostics
Laboratory diagnostics are of great importance in diagnosing microliths. Even in the usual general analysis of urine, various changes are detected - signs of inflammation( leukocytes, bacteria), increasing the composition and volume of salts, and blood in small amounts. Also in the general analysis of urine there is an increase in density, deviation of the pH level, the appearance of the cylinders.
Ultrasonography of the kidneys and bladder shows the presence of stones in the pelvis, in the ureters. Unfortunately, oxalate stones less than 6 mm in size are extremely poorly visualized by ultrasound, so even with a "clean" ultrasound picture, but in the presence of characteristic deviations in the urine, it is recommended that radiography( urography) be performed. Even more accurate technique is CT urography. The patient is given a contrast agent, after which a series of pictures is taken. This method of investigation will help to establish the form, shape, size and quantity of microliths.
When diagnosing microlithiasis by symptom it is important to distinguish from:
- Acute appendicitis;
- of acute pyelonephritis;
- Other types of urolithiasis;
- Tumor lesions of the kidney;
- Inflammation of the intestine, pelvic organs;
- Pancreatitis;Acute cholecystitis
- ;
- Osteochondrosis.
Treatment of
Before you begin to treat microliths in the kidneys, it is important to organize proper nutrition and change your lifestyle. The patient should walk as much as possible, engage in feasible sports - this is necessary to improve blood circulation in the kidneys and optimize urodynamics. A diet with certain rules will help stop the rapid growth of stones and sometimes even contribute to their dissolution and excretion from the kidneys.
Features of the diet for microlithiasis are as follows:
- When urates should limit the flow of purines - meat, soups, broths, alcohol. Proteins of meat can be replaced with proteins of eggs, milk, sour-milk food. Very useful for man vegetables, fruits, nuts, cereals.
- When oxalate, you can not eat foods containing oxalic acid - herbs, citrus, sour milk, tomatoes, some berries, sour fruit. Meat is also consumed in a limited way. In the diet should be more food, rich in magnesium.
- With phosphates, you need to remove food from the menu that causes an increase in the acidity of the gastric juice - acidic foods, alcohol, coffee, spices, spices. You can eat meat, fish, cereals, pasta, most vegetables, some fruits.
Medicated
Usually, microlithiasis is well suited for conservative therapy, but the doctor who prescribes how to treat it. As a rule, treatment with medicines begins with the administration of myotropic antispasmodics, along with diuretics. The first relax the musculature of the kidneys, the second wash the microliths from the pelvis. In parallel, in the presence of small stones, plant remedies are prescribed that improve the outflow of urine and have an anti-inflammatory and antibacterial effect due to the presence of terpenes:
- Cyston;
- Cysten;
- Kanefron;
- Spills;
- Enatin;
- Rovatinex;
- Nephrolith.
In case of renal colic, the patient is given Baralgin, or this drug or Revalgin, No-shpa is administered intramuscularly( intravenously).Inpatient treatment is carried out by treatment with spasmolytic drugs, drugs to improve renal blood flow, diuretics, if necessary - antibiotics. In childhood, vitamins A, E are necessarily prescribed, and acute pain can be removed with the help of non-steroidal anti-inflammatory drugs.
Folk remedies
It is not recommended for children to remove stones without prescribing a doctor using home techniques.
With the propensity to form microliths, preventive methods can be used:
- On a tablespoon of fruit and leaves of wild strawberries, boil in 400 ml of water in a water bath for 10 minutes. Strain after cooling, drink 100 ml three times a day for 14 days.
- Ceiling a tablespoon of cranberries with sugar to taste, pour warm boiled water. Insist 15 minutes, drink a glass of Morse a month a day.
- Mix radish juice with honey( 1: 1), drink a teaspoon twice a day after eating 2 weeks.
Adult folk medicine advises on its own to remove microliths from the kidneys with such folk remedies:
- Birch leaves( 10 g) pour 500 ml of water, cook for 10 minutes. Insist an hour, drain. Drink three times a day for 50 ml. This will help to remove sand and small stones.
- Dissolve a tablespoon of honey in a glass of water. Drink the whole serving in the morning on an empty stomach. Repeat until the stones come out, and there is no relief( 1-2 weeks).
Operative intervention
In the presence of small stones in the kidneys, surgery is extremely rare. Exception is the cases of clogging with a concrement of the ureter, for which its dimensions should exceed 6-7 mm. Nevertheless, many microliths continue to increase in size, which is especially often when ignoring diet or metabolic disorders.
As mini-invasive measures during the transition of the disease to the stage of nephrolithiasis, the following can be recommended:
- Laser crushing;
- Shock-wave crushing;
- Ultrasonic lithotripsy.
Open operations are performed in the presence of stones that occupy a large part of the pelvis of the right or left kidney, or as the stone is obstructed by the urinary tract. To prevent surgery, it is necessary to begin therapy of microlithiasis and a change in the way of life at the earliest stage of the disease.