Kidney stones

Introduction Renalcalculus is mostly located in the renal pelvis and renal parenchyma is rare. The plain film shows that the kidney region has single or multiple circular, oval or blunt triangular dense shadows with high density and uniformity. The edges are smooth, and the small stones in the renal pelvis and renal pelvis can move with the body position. The shape of the larger stones is consistent with the shape of the cavity, which can be expressed as a typical staghorn or coral. Sometimes stones can fill the entire renal pelvis and renal pelvis and resemble the performance of pyelography.

Cause

1. Too much accumulation of oxalic acid

The accumulation of oxalic acid in the body is one of the factors leading to kidney urinary stones. Such things as spinach, beans, grapes, cocoa, tea, oranges, tomatoes, potatoes, plums, bamboo shoots, etc., which people generally like, are foods with higher oxalic acid. The doctor found that 200 grams of spinach contains 725.6 mg of oxalic acid. If one person eats 200 grams of spinach at a time, 8 hours after eating, the oxalic acid excretion in the urine is 20 to 25 mg, which is equivalent to 24 hours for normal people. The average amount of oxalic acid.

2. Metabolic disorders

Animal viscera, seafood, peanuts, beans, spinach, etc., all contain more bismuth ingredients. After entering the body, the metabolism is carried out, and the final product of its metabolism is uric acid. Uric acid promotes the precipitation of oxalate in the urine. If, too much, the food rich in sputum is consumed too much, the metabolism of sputum is abnormal, and oxalate is deposited in the urine to form urinary stones.

3. Fat intake too much

Meat of various animals, especially fat pork, is a fat food. Eat more body fat will increase, fat will reduce the binding of calcium in the intestine, thus causing increased absorption of oxalate, if there is a discharge function failure, such as sweating, drinking less water, less urine, kidney stones It is likely to form in this case. Therefore, doctors often say that in order to prevent stone disease, you should drink more water on hot days. When you eat more oily foods, you should drink more water to promote smooth urination and dilute the urine components. danger.

4. Increased sugar content

Sugar is an important nutrient for the human body. It should be supplemented regularly, but it will increase too much, especially lactose, which will also create conditions for stone formation. Experts found that regardless of normal or calculus patients, after taking 100 grams of sucrose, they checked their urine for 2 hours and found that the calcium and oxalic acid concentrations in the urine increased. If lactose is used, it can promote the absorption of calcium. It is more likely to cause the accumulation of calcium oxalate in the body to form urinary stones.

an examination

B-ultrasound can initially diagnose kidney stones. Because B-ultrasound is simple, fast, inexpensive, and has no radiation, it is usually the preferred routine diagnosis. The urinary system X-ray can also be used as a review after initial examination and treatment, but it should be noted that 1/10 of the kidney stones are not developed on the X-ray, and are usually called "negative stones". Because the "bright spots" on the B- or X-slices are not necessarily stones, the diagnosis of kidney stones depends on CT and intravenous urography (IVU).

Through these "filming" examinations, it should be clear whether there are kidney stones, as well as the location, size, number of stones, whether or not combined with hydronephrosis, preliminary judgment of renal function, whether there is urinary system malformation and so on.

In addition, it is necessary to analyze the urine and blood, and obtain the stones and analyze the components of the stones, so as to understand the cause of the kidney stones and whether the infections are combined, etc., to provide a basis for the treatment of the cause and the development of preventive measures.

Differential diagnosis

Kidney stones need to be identified with the following diseases

1. Kidney tuberculosis Kidney stones combined with obstruction and infection should be differentiated from kidney tuberculosis. Kidney tuberculosis often has chronic stubborn bladder irritation. It has no obvious effect after general antibiotic treatment. There are pus cells in the urine, while ordinary urine culture has no bacterial growth, sometimes accompanied by tuberculosis or small tuberculosis of the kidney. Cystoscopy can show congestion and edema. Tuberculous nodules, tuberculous ulcers, tuberculous granuloma and scar formation are particularly evident in the bladder triangle and near the ureteral opening. The ureteral orifice is often cave-like, sometimes seeing turbid urine excretion. Calcified renal tuberculosis can be seen in the flat membrane with extensive calcification of the whole kidney, and focal lesions can be spotted with calcified shadows in the kidney. The early X-ray of renal tuberculosis showed that the edge of the renal pelvis was not neat, and there were worm-like changes. In severe cases, renal pelvis occlusion and cavity formation were observed, and the renal pelvis and renal pelvis were irregularly enlarged or blurred.

2. The incidence of sponge-spontaneous sponge kidney is 1/5000. The renal medullary collecting duct of the patient has a cystic expansion and has a general appearance like a sponge. There are bilateral renal lesions in 70% of cases, and there are 1 to several nipple involvement in each kidney. The disease is present at birth, but is asymptomatic, usually only 40 to 50 years old due to stones or infection complications. The expansion of the collecting tube causes long-term urinary retention, plus the often associated high urinary calcium disease, which is the cause of stones and infections. The tubular condensation and acidification functions are often impaired. Abdominal plain films showed normal or slightly enlarged kidney size, and clusters of multiple stones were visible in the kidney (radiated in the nipple area). The medullary collecting duct seen by intravenous pyelography showed a fan-like cystic dilatation as the basis for the diagnosis of this disease.

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