Kidney stones or Nephrolithen (v. Greek νεφρος “kidney” and λιθος “stone”) are deposits (urinary stones) in the renal veins, or urinary tract. The latter are considered ureter and bladder stones described. Other names are Nierenkonkrement or renalis Calculus.

The medical term for kidney stone disease or nephrolithiasis Urolithiasis.

Kidney stones can form in the renal pelvis, but it can also lead to crystallization in the kidney tissues, eg in Uratniere.

With kidney stones can cause renal dysfunction, eg by backwater of the urine into the kidney channels.

Most common are kidney stones from calcium oxalate. The formation of kidney stones can be increased oxalic acid values will benefit in some foods such as rhubarb and beetroot as well as tomatoes, spinach and chocolate are included.

Kidney stones arise, especially in times of increased fluid needs, such as in summer.

Abundance

The prevalence of kidney stones is approximately 5%. The ratio of affected men to women is the 7 to 5th Most often the disease occurs between 30 and the 50th Year of life. In the developed countries live approximately 20% of men and about 7% of women with an increased risk of stone. Is a kidney stone occurred, so is the risk of a relapse about 60%.

Assistants

Most commons is the division of kidney stones after its outer shape or their chemical composition:

* Classification according to the form:
* Valve stones
* Deer antlers stones
* Coral stones
* Ausgusssteine

* Classification according to chemical composition:
* Kalziumoxalatsteine (approx. 65%)
* Uratsteine (uric acid stones, about 15%)
* Magnesium ammonium phosphate stones (Struvitsteine, approximately 11%) occur mainly in connection with infections and are therefore also designated as infection stones.
* Calcium phosphate stones (approx. 9%)
* Cystinsteine (approx. 1%)
* Xanthinsteine (approx. 1%)

Also mixed forms are possible.

Causes

The emergence of Nephrolithen is complex and depends on many factors, depending on the composition of the concrements vary and not all details are clarified.

At the molecular level, there is an increase in the concentration of ions or other poorly Harnbestandteilen to exceed the so-called solubility. This starts these substances (salts) auszufallen and conglomerates to form, depending on the size of the urinary tract can no longer happen and deposition.

The increase Harnbestandteilen this can be done by a variety of circumstance factors. Besides Exsikkose (dehydration) and lack of liquid come here especially diseases in question, which increased Harnkonzentration of metabolites or ions require, including Hyperparathyroidism, hyperoxaluria, hyperuricemia (increased uric acid, gout) or certain infectious diseases. Also an ample intake of dietary purines on uric acid levels can increase. There are also disorders of the renal tubular acidosis, in which too much calcium phosphate excreted.

Anatomical peculiarities of the renal Harnleitersystems as horseshoe kidney and ectopic ureter, and Abstrombehinderungen favor stone formation.

Symptoms

The pinching of stones in the narrow confine of the ureter with urine encourages strong, wavy edge out the pain (renal colic). In general after some time, the affected kidney injury becomes visible in urine or the blood becomes detectable with the help of laboratory chemically. Infections are also possible. Small stones (<4 mm) can also come off without any particular complaints.

Investigative methods in cases of suspected kidney stones

* Ultrasound, while smaller stones are easily overlooked can be
* X-ray contrast presentation of the kidney and urinary tract (so-called Pyelogramm IV) (not suitable for displaying Urat and Xanthinsteinen)
* Examination of urine (for example, traces of blood = haematuria)
* Retro-grade presentation of urinary tract
* Endoscopic procedures
* CT
* NMR

Most frequently, the ultrasound examination, the urine analysis and the iv-Pyelogramm performed.

Medical importance

Kidney stones can be quite large and must be surgically removed.

The attempt by the body to eliminate kidney stones, renal colic often on (except Struvitsteine). The stones are as foreign by muscle contractions of the urinary tract in bladder pushed. They must pay by three bottlenecks. The resulting increased muscle contractions called pain, which as colic (renal colic) respectively.

Removal of Kidney Stones

Prior to the surgical removal (especially of kidney stones Beck) tries the stones by increasing urine or any new development. This is due to increased fluid intake and medication reaches the urination and the urine increase. Pure Urat and Cystinsteine alkalizing means can often be dissolved drugs (Urolitholyse). Another method involves the extraction of loop in which a catheter with a loop (loop Zeisssche) through the urethra into the ureter is introduced. Most of the stone is caught in the noose by a weight and try to it faster from the urinary tract to be removed.

Percutaneous Nephrolitholapaxie (PNL)

This method is used mainly in larger stones, which cause pronounced Harnstauungen. It is through a small incision an endoscopy introduced through the stone and then the shock waves will be smashed.

Extracorporeal Stosswellenlithotripsie (ESWL)

The lithotripsy (v. Greek λιθος “Stone” and τριβειν “rub”) or ESWL is the smash of urinary stones by shock waves. This may tend to a stationary interference waived. This procedure is attempted, using the bundled sound waves to the affected area will be addressed, and the foreign body without a percutaneously cut to crush the extent that it is either naturally or can be removed surgically.

Doctors of the University Hospital Grosshadern (Munich, Germany) first used the treatment method in 1980, and engineers and technicians of the Dornier Systems (Friedrichshafen, Germany) carried out successfully. The apparatus used HM2 (Human Model 2 “) was a bathtub, in which soil is a shock wave generator was embedded. The patient was in a special reclining under anesthetic placed in the tub. To locate the stone served two X-ray devices whose central rays are the focus of the shock wave generator and thus crossed the precise three-dimensional positioning of the stone allowed. The successor model of the “Dornier-bath”, the HM3 lithotripter has been distributed worldwide since 1983. Some of these devices are still in operation. Recent technological developments have led to the task of the water-bath for the benefit of a plastic bladder (Koppelbalg). Furthermore, with newer devices is the X-ray camera replaced by ultrasound? Established methods for shock wave generation electrohydraulic (spark gap), electromagnetic and piezoelectric generators. Today, worldwide more than 3,000 devices (Lithotripter) are used, approximately 90% of all kidney stones are in the industrialized countries on this gentle nature smashed.

Herbal medicine

Resolution can be done with the help of tea from real Labkrauts.