WHAT ARE RENAL STONES?
The concretions and stone-like bodies composed of urinary salts bound together by a colloid matrix of organic materials when in high concentration near or above maximum solubility.
CLASSIFICATION:
Depending upon the Location of calculi in the urinary system
When calculus present in renal tubules, they are known as Nephrolithiasis; in ureters, known as ureterolithiasis; in the bladder, known as cystolithiasis.
Facts about renal/ kidney stones:
- Affects approximately 1.2 million people each year
- Males are more prone than females (M/F 3:1)
- Affect anyone at any age even infants and children
What are the known risk factors?
- Sedentary lifestyle
- Dehydration
- Metabolic disturbances
- Immobilization or lack of physical activity
- Genetic history of renal calculi
- Recurrent urinary infections
- Drugs
TYPES OF RENAL STONES:
- Calcium salt stones(80%): calcium oxalate (small, mostly in ureters) and calcium phosphate (large, staghorn in the renal pelvis)
- Uric acid and urate stones(8%)
- Struvite kidney stones(10%)
- Cysteine stones- Rare type
- Xanthine- Rare type
- Indigo- rare type
SIGNS & SYMPTOMS
- Asymptomatic: Renal stones of size 3mm or more obstruct renal pelvis or ureter. Less than 3mm may lie dormant and are known as QUIESCENT CALCULUS.
- Renal Pain; which is a common symptom
- Fixed renal pain: The character of pain is dull, aching, or boring type, posteriorly at a renal angle and anteriorly in the corresponding hypochondrium. The pain aggravates while walking and ascending upstairs or jolting.
- Referred pain: this includes the diffuse pain felt all over the abdomen.
- Ureteric colic: the patient complains of sudden agonizing pain which radiates from loin to groin at scrotum /labia majora and the inner side of the thigh. This radiation of colicky pain suggests that the calculus is lying in the lower part of the corresponding ureter.
- When calculus is lying in the intramural part of the ureter, the patient is found to be in vain with painful straining at urination and pass only a few drops of blood-stained urine. This is known as STRANGURY.
This phase passes off in around 6-7 hours with compensatory polyuria or passage of calculus in the urine.
The accompanying symptoms may include:
- Urgency of urination
- Pus in urine
- Hematuria
- Oliguria (>400ml) or anuria (>100ml)
- Hydronephrosis
- Fever may accompany.
Signs: may include the following
- Tenderness at the renal angle posteriorly and anteriorly at the level of 9th coastal cartilage.
- Fixed Retroperitoneal swelling, oval in shape, ballotable due to hydronephrosis
- Rebound tenderness
- Muscle rigidity
- Distension of abdomen
- Diminished peristalsis which may cause Constipation
INVESTIGATIONS
- Blood examination reveals increased leucocytes count if calculus is accompanied by infection. Low hemoglobin due to inadequate renal function
- Urinalysis:
The physical examination reveals any change in color, quantity, odor, etc due to the presence of calculus or any associated infection
The microscopic examination reveals the presence of RBCs, Pus cells, proteins, casts or crystals, sediments in urine, etc
The chemical analysis of urine reveals the PH of urine. Consistently low PH is the common cause for the formation of Uric acid calculi. If the PH is more than 7.6, it suggests urea splitting organisms in urine and confirms the presence of triple phosphate stones.
Hence it helps in identifying the cause and clinicians may advise accordingly to prevent future recurrence.
- Check for increased serum uric acid, serum calcium, and vitamin d3.
- A kidney functional test should also be done if complications set in.
- Straight X-Rayy for KUB region may be helpful as 90% calculi are radio-opaque
- Ultrasonography
- CT Scan
- MRI
MANAGEMENT:
- It is advisable to drink water throughout the day. Avoid drinking fluoridated tap water as it is high in mineral content. Recommended urine output should be at least 2.5litres/day
- Consume a potassium-rich diet as it reduces the risk of renal stones.
- Increase the intake of citrus fruits. Orange and lemon juice may be consumed.
- Restrict foods rich in oxalate like rhubarb, beets, okra, spinach, sweet potatoes, nuts, tea, chocolates, soy products, etc in patients who tend to form calcium oxalate stones.
- Avoid high animal protein because it decreases the urinary excretion of citrate which acts as an inhibitor to the formation of calcium crystals and on other side increases the urinary excretion of calcium, uric acid and sulfurous amino acids (cysteine, methionine) which acidifies urine and contribute in the formation of calculi. Usually, protein diet restricted to 60grams/day.
- Sodium intake of 3-4grams/day is recommended because sodium competes with calcium for reabsorption in the kidneys.
- Avoid soft drinks containing phosphoric acid. Restrict alcohol intake as it may induce dehydration and increase the risk of stone formation.
- Do exercise or Yoga. Prolonged immobilization is also found to be a contributor to the formation of renal stones
- Avoid calcium supplements (calcium citrate) beyond limits; it can cause the formation of calculi.
HOMOEOPATHIC TREATMENT
Homeopathy is the second best-adopted treatment method used for any acute and chronic diseases worldwide. It embraces a natural, mild, and holistic approach to the treatment of renal stones. Homeopathic remedies are effective in dissolving the stones and its easy removal from the urinary tract without any side effects. Homeopathy is not only reduced severe colicky pain and other symptoms associated but also remove the tendency of recurring stone formation.
The size, number, and location of calculus are the most important predictors of analyzing its passage from the ureter or bladder. Sometimes the prognosis of treatment also depends upon the type of stones, side involved, and hydro nephrosis. The larger and multiple the calculi, more difficult, and time-consuming is its passage. The above information is helpful for the clinician to make better decisions about the treatment plan.
So it is advisable to consult a registered homeopathic physician for the treatment of renal stones.
WHY ORBIT CLINICS?
We at Orbit Clinics treated more than 1200 cases of renal calculi in last 10 years with promising results and less recurrence. The patients experienced instant relief in their pain and urinary complaints too. The common homeopathic remedies which are found to be effective in cases of renal stones are given below but we recommend to consult your registered homeopathic practitioner for the treatment and avoid self medication.
- Aconite nepellus
- Belladonna
- Berberis vulgeris
- Benzoic acid
- Cantharis
- Calcarea carbonica
- Hydrangea
- Lycopodium clavatum
- Natrum sulphuricum
- Nux vomica
- Ocimum canum
- Sarsaparilla
- Thuja occidentalis
