Renal Stones

URINARY CALCULI

Urinary calculi (Stones) can be various types and due to various reasons. The treatment remains the same with some minor variations, depending upon the type of stone.

The different types of calculi are:

Calcium, Phosphorus, Uric Acid, Cystene and Xanthene

The causes can be :

Hereditary tendency.
Hot climate and Dehydration.
Working in hot environment.
Decreased intake of water.
Diet rich in calcium oxalates.
Excess of vitamins D and C.
Deficiency of Vitamin B6 and Magnesium.
Chronic use of Calcium antacids.
High animal protein diet.
Sedentary lifestyle.
Certain kidney diseases and gout.
Symptoms :
Pain in the abdomen from back to groin or legs of a sudden onset.
Restlessness.
Nausea with or without vomiting.
Fever.
Red urine.
Pus in urine.
Painful urination.
Hardness of Abdomen.
Increased pulse rate.

Calculus formation is a gradual process extending over a long period of time and once a tendency to stone formation has developed it may persist throughout the life if not treated properly. Vigilance with fluid intake and diet is needed indefinitely.

The fundamental principle in the treatment of urinary calculi is to supply adequate fluids like water, coconut and barley water, lemon water, fruit juice and weak tea in order to ensure the passage of over 2000 ml (70 oz) of urine per day. A heavy manual worker in a hot humid climate, to compensate for the fluid loss through perspiration, should drink more fluids than a sedentary office worker in a cooler climate. Dilute urine avoids concentration of solids and also tends to make the urine neutral, thus preventing the strong acid or alkaline reaction which predisposes to precipitation of crystals. The simplest guide to the patient is to tell him to drink enough fluids to see that the urine is light in color.

Foods

Although the role of diet in the formation of urinary stones is not well established, it is advisable to restrict foods which are rich in calcium oxalate or uric acid, according to the type of stone formed. Thus, a person who has passed a calcium oxalate stone should avoid a diet rich in calcium and oxalate. If he cannot resist the temptation to eat strawberries or tomatoes occasionally, then he should drink additional water for the next day or two. It is also claimed that milk or cheese, if taken with food rich in oxalate, lead to the precipitation of non absorbable calcium oxalate in the intestine.

PREVENTION OF CALCULI

Urinary calculi may be due to hereditary metabolic defect and the exact role of diet is not settled. Yet people with a history to stone formation in a blood relation or those who have had renal colic can probably diminish their chances of calculus formation by the following measures:

1. By drinking enough fluid to excrete 2000ml (70 oz) of urine a day. During hot humid weather with excessive sweating, extra fluids must be taken.
2. As calcium oxalate is the commonest constituent of stones, restricting foods rich in oxalates reduces the risk.
3. By seeking prompt and adequate treatment for any urinary infection.
4. By moving as much as possible if confined to bed.

FOODS RICH IN OXALATE

Beef
Sapodilla {Chikoo}
Chocolates
Cocoa
Custard apple
Spinach
Strawberries
Tea
Tomatoes

URIC ACID

Fish Kidney
Liver
Meat extract
Soups
Sweetbread
Cheese
Paneer
Brinjal

CALCIUM

Beans
Cauliflower
Egg yolk
Figs
Milk and milk products
(butter and ghee need not to be restricted)
Molasses
Potatoes
Cheese
Paneer

During an acute attack of Renal Colic:

i) Do not panic
ii) If the pain is on left side, take Berberis-Vulgaris M.T., 3 drops every 10 minutes with little water till your doctor sees you.
iii) If the pain is on the right side, take Ocimum-Can M.T., 3 drops every 10 minutes with little water till your doctor sees you. Iv) Drink only liquids, no solid food.