Renal Stones

   
          INTRODUCTION
     These are problems of the urinary tract whereby stone formation are present.it is otherwise known as UROLITIASIS or NEPHROLITIASIS.
   Factors that can increase formation include;
-diseases
-nutritions
-hereditory
  The component of stone may be calcium or magnessium and radicals include oxalate and phosphate.

       CAUSES
       the causes are unknown but it may be due to;
-hereditory;when the kidney is unable to absorb cystein
-recurrent urinary tract infections;there will be urate splitting bacteria.when there is infections,it will not be able to prevent stone formation.example of urate spiltting bacteria include proteus,staphylococcus,mycoplasma species,klebseilla and pseudomonas.
-dehydration;this makes urine to be supersaturated and there may be stone formation
-excessive intake of calcium;in milk and alkaline solution.etc
-disease;like cancer,some granulomatous diseases,tuberculosis sarcoidosis,myeoloproliferative diseases.

SIGNS AND SYMPTOMS
-fever
-chills
-pains when urinating
-blood in urine
-pus in urine
-excessive sweating
-stone present in urine
-diarrheoa and abdominal pain

CLASSIFICATION OF STONES
 stones can be classified according to their chemical component,they are;
-calcium stones;these account for about 25% of all stones in the urinary tract and usually follow excessive calcium in the blood.
-struvite stones;they are called infections stone as some micro organism as been isolated to be the cause.they are the urate spiltting micro organism earlier discussed
-uric stones;this type of stone dissolve easily and account for like 5 to 10% of stone formed in the urinary tract.it is found in patient with gout and leukaemia.
-cystine stones;this type also is easily dissolved,they are uncommon and account for 1 to 2% of all stone formed in the urinary tract.they are due to defects in the kidney which are inherited which tends to inhibit renal absorption  of cystine.

    DIAGNOSTIC INVESTIGATIONS
-chemical analyis of stones
-complete urine analysis
-blood chemistry level  for sodium,calcium and uric acid
-ultrasonography of kidney,urether and bladder.
-retrograde pyelography
-intravenous urography of kidney,urether and bladder.
-microbial culture and sensitivity of pus inside urine

      TREATMENT
-analgesis
-non steroidal anti inflammatory drugs
-antibiotics
-antispamodic drugs
-reduction of diet that contains calcium and magnessium
-surgery to crush the stones
-surgery to remove big stones

     FOOD MANAGEMENT
-food rich in calcium phosphate;
  meat and diary product should be limited
    calcium oxalate;
      cashew,tea,chocolate,cocoa,beans,spinach and peanut

example of food that contains uric acid are;
   organ meat,meat extracts,mush room,grains,legumes and shell fish.

example of food rich in cystine include;
 meat,milk,egg and cheese.


     COMPLICATIONS
-infection
-hydronecrosis
-renal failure
-neurogenic shock