Doctors for Nephrolithiasis in Lakshmi Narayan Nagar, Hubli-Dharwad
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The formation of crystal aggregates in the urinary tract results in kidney stones, the clinical condition referred to as nephrolithiasis. Kidney stones might produce no symptoms or may be associated with one or several of the following: flank pain, gross or microscopic hematuria, obstruction of one or both kidneys, and urinary infections. The stones are usually formed by one of four substances: calcium, uric acid, magnesium ammonium phosphates (or struvite), or cystine.
HOW IS NEPHROLITHIASIS DIAGNOSED?
Stone analysis is the best method for diagnosing calcium oxalate or calcium phosphate stones. Calcium-containing stones are radiopaque on routine radiography but show up as bright objects on computed helical tomography without contrast. Ultrasonography detects all types of renal stones if the stone is larger than 3 mm and the ultrasound procedure is technically satisfactory.At present, helical computed tomography without contrast is the procedure of choice for the initial radiographic investigation. Of the conditions associated with calcium stones, only pyelo tubular ectasia—medullary sponge kidney—is better demonstrated by intravenous urography.
HOW IS NEPHROLITHIASIS TREATED?
The treatment consists of high fluid intake, dietary sodium restriction, and thiazide diuretics. An additional benefit of thiazide diuretics is that their chronic use is associated with preservation of bone mineral density. Dietary calcium restriction is not advised because of the potential for negative calcium balance and because a low-calcium diet increases the gastrointestinal absorption of oxalate and increased oxaluria. In hypercalcemic hypercalciuric stone-forming patients, the cause of the hypercalcemia should be sought and corrected. Correcting the metabolic acidosis in RTA and inflammatory bowel disease increases the urinary citrate excretion, an inhibitor of crystallization, and lessens the urinary calcium excretion.
DID YOU KNOW?
The kidney stones don’t cause any permanent damage but passing out the stones through urine can be extremely painful.