Coronoid kidney stones are one of the varieties of urolithiasis, the most severe and often requiring surgical intervention. About what symptoms are characteristic for pathology and how to treat it and diagnose it, will be told in the article.
Coral stones
Approximately 10-20% of cases of urolithiasis in patients are identified coral stones. It is a particularly large stone, difficult to treat in conservative ways. In people aged 30-50 years, pathology is more common than in other age categories. Women are more prone to developing this type of urolithiasis - 3 times compared to men. The danger of the disease consists in its latent flow in the early stages, in the lubricated symptomatology, which does not give the patient a reason to seek help.
Kidney stones, during which coral stones are identified, is called coral nephrolithiasis.
The size and location of the kidney pathology is classified into 4 types:
- The first type - the stone is in the pelvis and spreads to one cup.
- The second type - the stone is present in the pelvis in the part of the ureter, has processes in 2 or more cups.
- The third type - the stone is located inside the pelvis with the appendages in all the cups.
- The fourth type - the stone occupies the entire pelvis and all the calyxes, while deforming the system.
Coralloid stones cause an increase in pelvis and calyces, leading to impaired renal function. Without treatment, pathology can lead to kidney failure and chronic inflammatory processes.
Causes of
Such a serious disease, for the most part, occurs with progressive disorders of urodynamics and blood circulation in the kidney area, as well as in various types of pathologies of metabolism. Often coral stones are formed in people with congenital kidney disease and anomalies in their structure, with tubulopathies( a violation of the movement of electrolytes and other substances along the renal tubules).Hereditary transmission of this type of nephrolithiasis is observed in 20% of cases.
There are a number of risk factors that contribute to the development of the disease:
- Cardinal climate change;
- Consumption of poor quality water, food;
- Poor ecology;
- Diseases of the liver and gastrointestinal tract;
- Hyperthyroidism, parahyperthyroidism;
- Prolonged bed rest;
- Increased amount of salts in the urine;
- Pathologies of the heart, vessels.
Coral stones appear on the "matrix", or a skeleton of protein deposits. Then mineral salts are layered on the frame, the concrement grows in size and occupies the whole system of the renal pelvis( without treatment).
Features
Coral stone is a mineral with a special structure and appearance. By "appearance" it resembles a deer horn, a piece of coral( the latter comparison gave the name to a stone).The dimensions of education are varied - from a couple of millimeters to 7-9 cm and more.
The chemical composition of the calculus is often heterogeneous, in different layers may not be the same.
In the composition there is one or the whole set of the following substances:
- Compounds of oxalic acid and calcium( oxalates).
- Uric acid salts( urates).Calcium salts of phosphoric acid( phosphates).
- Salts of carbonic acid( carbonates).
In rare cases, concrements include protein, cholesterol, cystine( sulfur-containing amino acid).
Symptoms of
Most clinical signs of coral nephrolithiasis are similar to those of other forms of urolithiasis and some chronic kidney diseases. Usually the first stages of the disease do not occur at all without pathological signs, and only with large stones filling a large part of the pelvis and calyxes does symptomatology appear.
The onset of clinical manifestations is accompanied by such symptoms:
- Headache;
- Dryness in the oral cavity;
- Chills;
- High fatigue;
- Weakness;
- Dull pain in the lumbar region;
- Transient changes in urine output;
- Burning with urination.
All symptoms are caused by maintenance of a chronic inflammatory process, stagnation of metabolic products in the body and increased intoxication. In the presence of concrements of large size, the pain in the renal zone becomes almost constant. There may be a long subfebrile condition, weakness sometimes reaches pronounced values. Many patients periodically experience renal colic, blood appears in the urine, small parts of the stones depart.
The started stage of the disease is always accompanied by kidney failure. The outflow of urine is disturbed, pyelonephritis exacerbations often occur due to stagnation of urine and mechanical damage of kidney tissues. Duration of the disease in patients is not the same - some have years, others have a very large stone in a few months.
Diagnostics
Concrements of this type are easily detected when a routine ultrasound is performed, which allows to detect them at an early stage. In the presence of such symptoms as back pain, fatigue, changes in urine should be as soon as possible to make ultrasound, which will show the contours of the kidney, the size and location of the stone, the degree of expansion of the calyx and the violation of the shape of the pelvis.
Other methods of instrumental and laboratory diagnostics give such information:
- Radiography of the retroperitoneal space. Shows the shadow of the coral stone, its exact shape and size.
- Urography. It will help to determine the degree of kidney damage, evaluate their residual function.
- Cystoscopy. Will allow to determine the source of blood allocation, assess the function of the bladder and ureters.
- CT or MRI.Appointed in doubtful cases to clarify the diagnosis.
- Urinalysis. Reflect the inflammatory process, the presence of red blood cells, salts, often - pyuria( pus in the urine), help to identify the type of stones by urinary sediment.
- Blood tests. There is an increase in ESR, leukocytes, in the presence of renal failure - a decrease in creatine, the parameters of glomerular filtration.
Differentiate the disease according to the symptoms followed by other types of kidney stone disease, with polycystic kidney, chronic pyelonephritis, tumors, spine diseases.
Treatment of
Treatment of coronoid nephrolithiasis is a complex process. The sooner it is started, the more chances for recovery and prevention of the development of renal failure, chronic pyelonephritis. The goals of treatment for a urologist and nephrologist are to influence the cause of the pathology( if possible), to prevent the growth of the stone, its dissolution or removal.
Folk methods
The effectiveness of traditional methods of treatment will be the highest with urate stones. But if there is a coral stone in the kidney, then unconventional prescriptions are intended for normalization of metabolism, removal of the inflammatory process, which will help stabilize the state of kidney health.
Often the treatment of coral stones in the kidney occurs with such folk remedies:
- 2 tablespoons of white raisins pour warm water( 600 ml), leave overnight in a thermos. In the morning, drink a third of the infusion on an empty stomach, eat a third of the raisins. Repeat the treatment 2 more times a day, using the divided into equal parts of the liquid and raisins. The course of treatment will end when a kilogram of raisins is consumed.
- To connect equal parts of celandine grass, barberry bark, oregano grass. A tablespoon of the mass pour a glass of boiling water, insist half an hour. Drink a glass at a time once a day for 21 days.
- In the morning before eating for 14 days, eat 1 gram of carrot seeds( it is believed that this method can dissolve kidney stones).
Medication
Only a doctor can choose a specific scheme for the treatment of coral nephrolithiasis, especially since conservative therapy has not been shown to all patients. How to treat will depend on the composition of the stones, the size and stage of the process.
If stones consist of uric acid, the following drugs are used:
- Urofuyuks;
- Avisan;
- Allopurinol;
- Blomaren;
- Olimethine.
Also, the patient can be recommended taking Urolesan - a drug that removes small stones from the kidneys due to spasmolytic and diuretic effects. In general, the use of diuretics during therapy is mandatory for the washing of crushed stones.
When coral stones are often prescribed:
- Vitamins B, A, E to improve the performance of renal nephrons.
- Drugs for the normalization of phosphate-potassium metabolism.
- Non-steroidal anti-inflammatory drugs against severe pain.
- Antibiotics in the presence of an inflammatory process.
Usually dissolution of stones is carried out not less than 3-4 months. In the late stages of pathology, such treatment regimens are ineffective, but the use of restorative drugs or antibiotics, symptomatic drugs is practiced.
Surgical intervention
Indications for nephrolithotomy( kidney calculus removal) are:
- A large stone that can not be dissolved with drugs. Disruption of urinary outflow, acute condition.
- Decreased kidney function, development of renal failure.
- The appearance of complications - suppuration, inflammation, deformation of the kidney.
- No effect on tablets, preparations.
- Macrogematuria, especially recurrent.
The operation to remove coral stone from the right or left kidney is performed through laparoscopic access. The surgeon removes the stone, cleans the pelvis from its particles. It is possible to perform another type of intervention - removing the stones with a fibroscope through a small puncture. Preliminarily, the stones are crushed with a laser, an ultrasonic wave, and a lithotriptor. Excellent results give a crushing of stones with their phosphate or mixed composition, but urate and oxalate stones are not always crushed successfully. In case of severe illness it is necessary to remove the entire kidney, however, such operations are very rarely performed now( no more than 5% of cases).
On the video about the removal of the coral stone from the kidneys surgically:
Diet
Proper nutrition should be organized both during the treatment of coral nephrolithiasis and after surgery, because kidney stone disease can manifest itself again. It is important to reduce the number of foods high in calcium, which can accelerate the growth of stones. Also, you need to reduce salt intake, so as not to overload the kidneys, not to provoke swelling and stagnation of urine. Products with an abundance of organic acids also adversely affect the condition of the kidneys and accelerate the progression of the disease. Remove from the menu you need and fatty foods, with vinegar, sharp.
Thus, in the menu there should be a minimum of such food:
- cottage cheese;
- cheese;
- sour-milk food;
- fruit;
- berries, especially, sour;
- salt;
- spices;
- fatty meat;
- soda.
Cereals, starchy vegetables, fish, lean meat, vegetable oils, butter, juices and fruit drinks, soups, bread are allowed. The amount of water is up to 2 liters / day.
Prevention
Prevention measures are aimed at bringing about a normal metabolic rate and improving kidney function. For this it is important to lead a healthy lifestyle, exercise in exercise therapy and affordable sports, eat the right food. The diet is selected by a doctor and is strictly observed( if there are stones in the anamnesis or a tendency to form them).It is useful to take phytopreparations, water procedures, the optimal drinking regime.
On the video about coral nephrolithiasis: