Kidney and Ureteral Stones

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Kidney stones are small, solid deposits that form in the renal pelvis. When they migrate into the ureter, they are referred to as ureteral stones. Kidney and ureteral stones are also sometimes referred to as urinary stones.

Kidney stones are formed when certain substances in the urine, such as calcium, uric acid and other minerals that are normally dissolved, break down and clump into small crystals. In the course of many diseases, it can happen that the concentration of these substances in the urine changes and exceeds the limit of their solubility.

These factors favour the formation of kidney stones:

  • Dehydration

  • Diet rich in salt and protein

  • Anatomical particularities of the kidneys (e.g. renal artery stenosis)

  • Diseases of the parathyroid gland which lead to a higher excretion of calcium via urine

  • Certain conditions, such as gout, diabetes or chronic diarrhoea, which promote the formation of uric acid stones

  • Family predisposition

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Small stones are transported to the bladder, from where they are excreted in the urine within a few days or weeks without treatment. If there are symptoms, often, it is sufficient to take pain relievers, drink plenty of water, move for a certain amount of time, and wait. For medium-sized stones, medications that relax the muscles can help with eliminating them.

Larger stones (more than 10 millimetres in diameter) can get stuck when exiting the renal pelvis, or slowly migrate through the ureter, causing very severe pain (colic) and other symptoms such as nausea. These stones are too large for them to be passed spontaneously.

Therefore, depending on the type, location and size, these stones must be

  • destroyed with shock waves (extracorporeal shock wave lithotripsy),

  • removed endoscopically, or

  • operated upon, in rare situations.

Recommendations are at the forefront of aftercare, so that you do not develop new kidney stones. In about 30 % to 50 % of people who have been treated for kidney or ureteral stones, deposits rebuild within five years.

These are the key aspects:

  • Drink an adequate amount of fluids: two to three litres per day.

  • Eat vegetables and fruits like citrus.

  • Exercise a lot.

  • Avoid foods rich on oxalate, such as spinach, beetroot, Swiss chard, rhubarb, black tea, coffee, cola, chocolate or nuts.

  • Consume animal protein moderately. We recommend a maximum of 5 meals with meat per week. Proteins from dairy products are less problematic, because the calcium contained in the milk already binds the oxalic acid in the intestine so that it is hardly absorbed.

  • Use salt sparingly.

  • Be sure to have your doctor explain what the stones you developed were composed of. Subsequently, you can change your diet accordingly to prevent the formation of other stones.

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