Kidney stones
Kidney stones are a chronic, recurring condition that compromises quality of life. Stones are concretions formed from various mineral salts and originate in the kidneys or urinary tract. It affects 15% of the population.
Its cause is multifactorial and its risk increases due to factors such as the composition and concentration of minerals in the urine, with calcium stones being the most frequent (75-80%), and of these, calcium oxalate stones; urinary pH, deficiency of inhibitors in the urine (citrate, magnesium), anatomical alterations, and metabolic, infectious, or drug-related factors.
Idiopathic hypercalciuria is its most frequent cause, it is associated with extrarenal diseases (metabolic syndrome, obesity, hyperparathyroidism, cancer, gout, intestinal diseases, hypervitaminosis C and D) and with osteoporosis.
Its symptoms include pain, discomfort when urinating, reddish urine, or asymptomatic periods. Renal colic is an acute pain accompanied by nausea, vomiting, sweating, and coldness.
Kidney stones can be complicated by obstructive or infectious processes, and can be a risk factor for chronic kidney disease or squamous cell carcinoma. Mortality is rare, and permanent kidney damage occurs in 1-2% of dialysis patients.
Treatment should focus on preventing recurrence, not just removing the stone. It's important to identify the underlying causes and implement general measures such as increasing water intake, reducing salt consumption, avoiding diets high in animal protein and purines, ensuring a daily calcium intake of 1g (lower intake increases the risk of kidney stones), maintaining a healthy lifestyle, and avoiding prolonged urine retention. These measures are effective in preventing recurrence in uncomplicated cases.
In cases of complicated or multiple stones, or recurrences, pharmacological treatment is indicated based on the etiological diagnosis, the presence of risk factors, and concomitant diseases. Interventional therapies may be required for stone removal; these procedures (lithotripsy, endoscopic surgery) are safe.
Dr. Lucia M. Gonçalves Jardim
Internal Medicine Physician.
Specialist in Endocrinology and Metabolism
Email: luciamgoncalvesj@gmail.com
Telephone: +351 939 056 458