Natural Remedies for Kidney Stones
In ultrasound scanning, images are created using ultrasound waves (high-frequency, inaudible sound waves). A device called a transducer is moved over the skin or, in some cases, inserted into a body opening such as the vagina or rectum, and sends ultrasound waves into the body. Where tissues of different densities meet, or where tissue meets fluid, the waves are reflected the transducer picks up the echoes and passes them to a computer, which creates an image on a monitor. The images are updated continually so that movement can be seen. Doctors often use ultrasound to look at fetuses in the uterus (see Ultrasound scanning in pregnancy, p.280) or the walls and valves of the heart, or to detect abnormalities such as cysts and kidney stones. A technique called Doppler ultrasound scanning (p.235), which shows the direction and speed of blood flow, is used to detect problems such as narrowed arteries or clots in veins.
Calcium and vitamin D supplementation is the cornerstone of all treatment modalities for osteoporosis. Literature clearly shows that adequate calcium and vitamin D intake reduces the risk of fractures. For optimal treatment, adequate calcium intake of 1000 to 1500 mg day should be maintained in all patients on any type of treatment. To maximize the absorption of calcium across the small bowels, no more than 500 to 600 mg of elemental calcium should be taken at any given time. Among all calcium formulations, calcium citrate is the preferred form. Calcium citrate binds to oxalate, reducing its intestinal absorption, and citrate in urine inhibits crystal formation, thus reducing the incidence of kidney stones. In addition, calcium citrate does not require low pH for salt dissociation therefore the absorption of this calcium formulation is reliable in patients taking H2 blockers or proton pump inhibitors.
Corlew and associates36 reported a more carefully explored series of 47 patients with primary HPT who either refused surgery or were not offered this option, some of whom were considered poor surgical risks. The diagnosis was accurately established in these patients by measurement of albumin-corrected serum calcium and intact PTH. The patients were classified into three groups on the basis of their levels of serum calcium one fourth had serum calcium levels higher than 2.78 mmol L. Sixteen of the 47 patients (34 ) either died or suffered from complications that the authors considered to be possibly related to primary HPT, such as peptic ulcer disease (8 patients), with bleeding in some cases renal failure (5 patients) renal calculus (1 patient) hypercalcemic crisis (1 patient) and ventricular conduction defect (1 patient). With the exception of the patient with hypercalcemic crisis, who initially belonged to the group with the lowest serum calcium levels, the serum calcium levels did...
The clinical manifestations of HPT tend to be related to the level of hypercalcemia, even if this is not always evident because of slow disease progression, individual susceptibility, and to some extent also gender and age dependence of symptoms.45 Younger men are particularly likely to experience renal stones, sometimes even with only mild hypercalcemia. For renal stones, the individual susceptibility is more important than the level of hypercalcemia, and the risk for this particular symptom is probably most efficiently revealed by the patient's history. Urinary calcium excretion has been an uncertain predictor of the risk for kidney stones among patients who have previously not had this symptom.46 Males excrete 25 to 30 more calcium in the urine than females, and whites also have higher excretion than blacks.46 In postmenopausal women, renal stones occur infrequently (generally less than 5 ) and are often clinically silent.
This study shows that data monitoring committees need to consider how long to wait to see if the benefit appears and counterbalances the known risks. Even though the primary outcome was not sufficiently adverse early in the trial to justify stopping, other factors combined with lack of benefit might have influenced a monitoring committee to do so. For example, in POSCH, there were side effects such as diarrhoea and, more seriously, a higher rate of kidney stones and gallstones.27 The slight early adverse trend in mortality plus the increased morbidity could have led to a decision to stop the study prematurely.
In patients with normal gallbladder function, effective agents for eradication of chronic carriage include amoxicillin (3 g divided three times a day in adults for 3 months), trimethoprim-sulfamethoxazole (one double-strength tablet twice a day for 3 months), and ciprofloxacin (750 mg twice daily for 4 weeks). In patients with anatomic abnormalities, such as biliary or kidney stones, surgery combined with antibiotic therapy is indicated.
Vitamin C (ascorbic acid) is an important water soluble antioxidant that competitively protects lipoproteins from peroxyl radical attack while also enhancing the antioxidant activity of vitamin E by assisting in its recycling. Seminal plasma vitamin C levels are tenfold higher than serum 181 , suggesting a very important protective role for vitamin C in the male reproductive tract. The RDA for vitamin C in the adult male is 75 mg, with the tolerable upper intake limit being suggested as 2,000 mg day 179 . While some trials have used vitamin C supplementation at doses as high as 1,000 mg day, lower-dose supplementation such as 100 mg day is probably more preferable, since vitamin C can act as a pro-oxidant at high concentrations in the presence of iron 182 . Furthermore, high-dose vitamin C may also lead to the development of kidney stones and cause side effects such as nausea, abdominal cramps and diarrhoea.
Since the beginning of recorded history, the external genitalia and the urologic system have been of special interest to people. Kidney stones and urologic surgery were well described in antiquity. One of the earliest reported kidney stones was found in a young boy who lived about 7000 BCE.
Population studies in both America and Europe reveal prevalence rates for renal stone ranging from 3 to 13 percent. Nearly 75 percent of these people with so-called idiopathic calcium stone disease have one or more recurrences, implying a continuous exposure to risk factors such as diet. The incidence of the disease has risen continuously since the turn of the century except for brief declines during both world wars - again pointing to dietary changes as an important factor.
There is good evidence that in about 80 of patients the clinical manifestations improve after successful parathyroidectomy.8'9,10'46'47 Thus, fatigue, exhaustion and weakness, polydipsia, polyuria and nocturia, bone and joint pain, constipation, nausea, and depression improve in some patients.8 I0'46'47 This is also true for associated conditions. In these patients, new kidney stones usually stop forming, osteoporosis stabilizes or improves, peptic ulcer disease often resolves, and pancreatitis becomes less likely.4647 Thus, both neuropsychiatry and somatic problems improve in most, but not all, patients (Figs. 40-1 to 40-4).10-48 Increased fracture risk and weakness also improve after successful parathyroidectomy in most, but certainly not all, patients.1948 Objective increase in muscular strength has also been documented after successful parathyroidectomy.49 Patients can also resume a regular diet with or without calcium supplementation and hypercalcemia is not a concern when...
Mild to moderate hypercalcemia may be manifested only by anorexia, malaise, weakness, osteoporosis, and kidney stones. When these manifestations develop slowly, as they do in many mildly hyperparathyroid patients, their presence may be recognized only retrospectively, after parathyroidectomy.7'26 Hypercalcemia causes anorexia, polyuria, nausea, and vomiting, and the resultant dehydration may be profound.9 Isolated components of the syndrome are often nonspecific and observed in many other diseases,10 but the simultaneous presence of several of these components strongly suggests hypercalcemia.
Comorbid medical and psychiatric conditions can complicate preventive treatment strategies. For example, asthma precludes use of beta-blockers, obesity mitigates against use of weight-gaining medications such as tricyclics and valproate, and kidney stones and glaucoma suggest extreme caution for the use of topiramate (if it should be used at all). Vascular disease contraindicates the use of triptans and ergots. The more comorbidity, the more attractive onabotulinumtoxinA appears, the only FDA approved preventive medication for chronic migraine.
The urinary excretion of calcium and inorganic phosphate in 344 patients with calcium stones of renal origin. Br I Surg 1958 46 10. 30. lohansson H, Thoran L, Werner L, et al. Normocalcemic hyperparathyroidism, kidney stones, and idiopathic hypercalcuria. Surgery 1975 77 691.
V Kidney stones (renal calculi) are accumulations of crystals that are condensed from the urine. The size of a stone, or calculi, is not as much of a concern as is its shape (smooth or spiked) or site of lodging. Stones that form in the renal pelvis are not problematic. However, if (and when) the stone moves into the ureter, the stone may serve as a dam and prevent or partially prevent the flow of urine. The pressure buildup causes much of the pain associated with kidney stones.
Families with multiple instances of IBD show an intermingling of ulcerative colitis and Crohn's disease. Both diseases share the same epidemiological and demographic features. They also share many symptoms (abdominal pain, diarrhea, weight loss, rectal bleeding), local complications (hemorrhage, perforation, toxic dilatation of the colon), and systemic complications (erythema nodosum, pyoderma gangrenosum, arthritis, liver disease, kidney stones).
Planned adrenalectomy, planned lymph node dissection, gastro-esophageal reflux disease, hypertension, smoking, diabetes mellitus, hyperlipidemia, chronic obstructive pulmonary disease, coronary artery disease, hematuria (micro or gross), kidney stones, obstructive sleep apnea, congestive heart failure, cerebrovascular accident, polycystic kidney disease depression, fibromyalgia, liver cirrhosis, bleeding disorders, planned transperitoneal versus retroperitoneal approach, side of nephrectomy, tumor size, nodal involvement, renal vein involvement, body mass index, American Society of Anesthesiology grade, planned specimen extraction incision and duration of hospital stay (in days).
PTX is indicated in some patients after kidney transplantation because of clinical manifestations similar to those of primary hyperparathyroidism hypercalcemia plus nephrolithiasis, acute pancreatitis, changes in mental status (lethargy, irritability, confusion), or overt bone disease.10 Mild hypercalcemia alone does not appear to be a serious threat to the patient with a transplanted kidney, but impaired renal function in the presence of high PTH and hypercalcemia should be an indication for PTX,11'12 as is the association of kidney stones and long-standing hypercalcemia.13'14 Whether asymptomatic hypercalcemia alone is an indication for PTX in renal transplant recipients is controversial.
Nociceptive pain is triggered when receptors detect injury or irritation. Acetaminophen, local anesthetics, nonsteroidal anti-inflammatory drugs (NSAIDs), opioids, and or steroids are indicated for somatic pain (i.e., sharp localized pain caused by activation of Adelta fibers located in peripheral nerves), such as lacerations, burns, needle procedures, abrasions, and ear or skin infections. Cold packs and tactile stimulation can also be helpful. For neonates, breast milk and or oral sucrose can be helpful for one-time injection pain (Shah et al. 2007). Intraspinal local anesthetics, NSAIDs, opioids, and or steroids are indicated for visceral pain (i.e., generalized pain that can be dull or sharp, caused by activation of C fibers with deeper innervation), such as joint pain, muscle pain, kidney stones, appendicitis, or sickle cell pain. Surgical pain is typically related to activation of both A-delta and C fibers and is responsive to NSAIDs and opioids.
The complications of regional enteritis include most of the problems enumerated for ulcerative colitis and, in addition, perianal abscess, perineal fistulas, abdominal abscess and fistual formation, intestinal narrowing and obstruction, carcinoma of the small and large intestine, and obstructive hydronephrosis. In patients with multiple bowel resections and significant loss of intestinal digestive capacity, the complications include altered bile salt metabolism, steatorrhea, increased absorption of dietary oxalate and hyperoxaluria, increased frequency of kidney stones, zinc and magnesium deficiencies, other nutritional deficits including vitamins B12 and D, bone demineralization, and osteopenia.
Despite some unproven claims for light and sound therapies, both light and sound are used in conventional medicine. Light therapy successfully treats seasonal affective disorder (SAD), a psychiatric syndrome of depression caused by reduced natural light in winter months. Sound is used in conventional medicine for both diagnosis and treatment in the form of ultrasound, or high-frequency (outside of human hearing range) sound waves. Ultrasound used for diagnostic purposes explores the heart, checks fetal development, and examines other areas of the body, all painlessly and easily. In one treatment, ultrasonic waves are sent through water to painlessly enter the body and destroy kidney stones.
Peak bone development occurs throughout adolescence, with smaller bone gain during the 20s and less calcium needed at this age. Bone loss starts with menopause for women, which increases the need for calcium and vitamin D to prevent bone loss. High dietary intake of calcium does not seem to present any risk previous concern about kidney stone formation with increased calcium intake appears to be unfounded (Curhan et al., 1997). Side effects of high calcium supplement intake include constipation and dyspepsia, and calcium supplementation with more than 2000 mg day of vitamin D may lead to soft tissue calcification.
White cells are inflammatory markers, so infection cannot be confirmed by their presence or ruled out by their absence. Common causes of sterile pyuria include STIs, kidney stones, prostatitis, and urinary tract neoplasms. In children, pyuria may occur during a febrile illness, even if a UTI is not present (Graham and Galloway, 2001).
Pus in the urine, or pyuria, is the body's response to inflammation of the urinary tract. Bacteria are the most common cause of inflammation resulting in pyuria, although pyuria is also seen in patients with neoplasms and kidney stones. Cystitis and prostatitis are common causes of pyuria.
Many remote stones were never well documented, and often, muscle skeletal pain is assigned the diagnosis of kidney stone. Metabolic workup including serum studies and two random 24-hour urine studies are recommended. When metabolic studies are normal and imaging shows no evidence of stones, the donor evaluation should be continued. In older adults with a small, unilateral stone, the affected kidney may be taken in donation because the future risk of stones is very low.
Approximately 5 to 12 of adults will have a kidney stone, and the chance of a recurrent stone is 50 (Parmar, 2004 Teichman, 2004). Whites have the highest risk, particularly men. Family history increases the risk threefold and is present in 55 of recurrent stone formers (Teichman, 2004). A classic history suggesting renal calculi is the abrupt onset of unilateral flank pain. It often radiates into the groin and may be accompanied by nausea and vomiting. Patients with kidney stones typically have great difficulty finding a comfortable position. On examination, there may be costoverte-bral angle or lower abdominal pain, and hematuria occurs in 90 of patients (Teichman, 2004). Patients may experience UTI symptoms such as dysuria, frequency, and urgency as the stone passes from the ureter into the bladder. However, patients with fever, microscopic signs of infection, or signs of systemic sepsis may have superimposed UTI. Complete obstruction and hydronephrosis can result in renal failure....
A 35-year-old man with a history of a kidney stone in his ureter was referred for persistent primary HPT after cervical exploration. During the initial cervical exploration. which was judged to he reasonably complete, all four glands were visualized, and biopsy of the left inferior gland confirmed normal parathyroid tissue. Alter the biochemical diagnosis of primary HPT was reconfirmed, US revealed no abnormality, whereas TSS showed a suspicious uptake in the mediastinum near the left main bronchus (Fig. 58-3). although the CT scan failed to demonstrate any definite abnormal mediastinal gland. Mediastinal exploration was performed that revealed a 2()-g intrathymic parathyroid adenoma. The adenoma was excised, and the patient's calcium level relumed to normal postoperatively.
Carbonic anhydrase inhibitors, such as methazolamide (Neptazane), lower IOP and decrease aqueous production. Carbonic anhydrase inhibitors, such as acetazolamide (Diamox), cause increased urination, decreased appetite, headache, nausea, malaise, and kidney stones. Additionally, these medications lower the serum potassium level, particularly in patients taking diuretics. Potassium supplements should be prescribed to prevent hypokalemia.
51 Tips for Dealing with Kidney Stones
Do you have kidney stones? Do you think you do, but aren’t sure? Do you get them often, and need some preventative advice? 51 Tips for Dealing with Kidney Stones can help.