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 DEFINITION
The renal litiasis, also so called urolitiasis or nefrolitiasis is an illness caused by the presence of calculations or stones inside the kidneys or of the urinary tract (uréteres, bladder).
The kidney stones consist of normal substances of the urine, but for different reasons they have concentrated and hardened in fragments of major or minor size.
It is a frequent affectation that affects more than 10 % of the population, in middle age of the life and more frequent in the men. It prevails in persons with sedentary habits or in persons with big exhibition to the heat.
SYMPTOMS
The kidney stones can cause different symptoms, depending on his size, composition and of his situation in the urinal device. Some for his small size it can happen unnoticed.
- Syndromes that can take place in the renal litiasis:
- Nephritic colic. On having gone out, the calculations of the kidney produce a taponamiento of the exit of urine of the kidney producing to him the untensest pain, which appears in the renal area (lumbar ó low back) and it is radiated towards the previous abdomen towards the genitals. It is an intermittent pain that does not get better and collaborates to morning sickness, vomiting, sudoración and sensation of abdominal distension. It usually does not give fever.
- Waist pain. It is a persistent and slier pain in the lumbar area
- Hematuria. That is the blood appearance in the urine. It can be visible to simple sight or sometimes only microscopic. It takes place for the injuries that the calculation produces in his step along the structures of the kidney.
- Urine infections. For his situation some calculations only are discovered by frequent infections of the urine.
The content of the calculations can be:
- Calcic Oxalato
- Calcic phosphate
- of the miscellany of both salt that is the most frequent composition of the calculations. The causes of his production can be one or several simultaneously (to drink little water, calcium excess in the meals or for familiar heredity)
- The uric acid calculations are less frequent and they take place when the urine is acidified. These calculations are not seen in the radiography (they are not radiopacos), by it to observe them there is needed the application of contrasts or the ultrasound scan.
- The phosphate calculations amónico magnésico, they are very aggressive for growing very quickly, they usually collaborate to renal infections.
- The cistina calculations appear in the infancy if there exist illnesses associated with alterations of the metabolism of the cistina.
DIAGNOSIS
Necessary knowledge is the situation and size of the calculations, his composition and the possible existence of illnesses that collaborate to his formation.
The situation and size is realized by means of:
- Simple radiographies
- Urografías with contrast
- Ultrasound scans
The composition of the expelled calculations is realized by means of specific analyses.
The presence of associate illnesses is realized later and depending on the composition of the calculations.
TREATMENT
The treatment of the pain is realized especially in the nephritic colic, by means of analgesics, increase of the water consumption, soft diet and rest.
In half of the cases the calculation is expelled within 15 days, and in the majority before 2 months.
If the expulsion does not happen spontaneously it is possible to realize:
- Extracorporeal Litotricia with shock waves. By means of this method the calculations break in small fractions that can be expelled more easily (efficacy of 90 %)
- Endo-urología. A puncture is realized in the back at a height of the kidneys or for the urinal conduits (urethra, bladder, etc.)
- Surgery. Only it is realized before the mistake of other systems of treatment.
The preventive measurements are necessary since half of the persons who have suffered a calculation, has other again within 10 years.
- To consume 3 daily liters of liquid
- The balanced and varied feeding
- To avoid the urinal infections and to treat them if they appear, correctly
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DEFINITION 
