Treatment and diet for urates in the kidneys. Treatment and Dissolution of Urate Stones with Diet

In contact with

Classmates

Leave a comment 5,973

One type of urolithiasis is urate kidney stones. This anomaly is the 2nd most common in humans. As a rule, it is fixed in the period from 20 to 55 years. Urate stones in older people are found in the bladder, and in young people - in the kidney organs and ureters. The formation of calculi not detected in time is dangerous with severe complications.

Pathologies with impaired metabolic processes, due to which urate stones and other insoluble compounds are formed in the renal organs, are called urolithiasis. The formation of urates is characteristic of the strong half of humanity. Urate stones are colored yellow-brown, with a relatively smooth structure. The kidney, ureter, and ureter are the organs in which uric acid stones form. A dangerous deterioration is the transformation of urate stones into coral-like ones, this is fraught with diseases such as pyelonephritis and chronic renal failure.

Causes of urate kidney stones

According to experts, the emergence of a pathological process in the form of the formation of urate stones in the body is facilitated by various reasons that act in combination or separately, they include:

• genetic predisposition. Urolithiasis is inherited, as an example, high levels of calcium in the body (calcium is the building material for stones in most cases).
• An increase in salt concentration due to a failure of metabolic processes. This will lead to disturbances in the natural balance of trace elements, a salt precipitate will appear, from which stones will begin to form.
• Monotonous nutrition can serve as a factor in the development of stone formations.
• Place of residence of a person. There are geographic locations where cases of urolithiasis are more often recorded. To avoid this, the body's water balance should be maintained.
• A certain composition of the water consumed can influence the progression of the disease.
• Insufficient amount of B vitamins.
• Favorable conditions for the development of the disease - hard work; passive lifestyle; bad habits, starvation.
• The use of a large amount of analgesic drugs.
• Sour urine reaction. Acid indicators can be detected using specialized rapid tests. Indicators are normally considered from 6.0 to 7.0.
• Excessive content of uric acid salts in urine. Salts are the end product of protein metabolism in the body, always present in urine. To change to an alkaline reaction, you should eat a lot of vegetables, fruits and dairy products.

Back to index

Symptoms

The main danger in the occurrence of stones is that for a long time the symptoms do not appear. In the later stages, the main symptom of the presence of urate stones in the body is renal colic and its characteristic manifestations:

• sharp pain in the lumbar region;
• pain sensations spread to all organs of the genitourinary system (from the bladder to the adrenal gland);
• pain attack cannot be stopped;
• the presence of trembling in the body;
• nausea and urge to vomit;
• excessive gas formation;
• pain when urinating;
• gout;
• visual deviations from the parameters in urine (turbidity, sandy sediment, blood inclusions).

An increase in body temperature is an alarming symptom that indicates an emerging inflammatory process in the renal organs. The development of renal colic occurs during the interference of the calculus in the normal outflow of urine. At the first sensual or visual changes in the body, you should consult a specialist, the pathology detected in time is corrected much faster than the neglected state.

Diagnostics

Men are more prone to the formation of urate stones in the body. This is attributed to the fact that the male sex has a more pronounced preference for meat and dishes from it. The resulting excess uric acid provokes the formation of urate stones and gout. However, women more often endure a severe form of urolithiasis, namely formations in the form of large staghorn stones. During the diagnosis and selection of effective therapy, the existence of chronic diseases, namely coronary heart disease, diabetes mellitus, obesity, gout and hypertension, should be taken into account. To make an accurate diagnosis, an examination is prescribed, consisting of:

• general blood test;
• deep laboratory studies of urine;
• urography (survey and excretory);
• ultrasound examination of the organs of the urinary system;
• spiral computed tomography (CT);
• magnetic resonance imaging (MRI);
• contrast fluoroscopy (plain x-ray is not effective).

Back to index

Treatment of pathology

General principles of conservative treatment

Specificity of a simple degree of pathology in light dissolutions of urate formations. Conservative methods contribute to the development of a favorable outcome. Urate stones dissolve under the influence of the consumption of a large volume of liquid, which triggers a change in the pH of the urine - the acidic state is converted to alkaline. In this therapy, nutrition plays an important role, namely, a large consumption of vegetable and dairy products is introduced into the human diet and the intake of alkaline mineral waters. If such measures are not able to dissolve urinary salts, then treatment with medications or surgery is prescribed.

Therapy with drugs

Treatment of urate kidney stones, with the help of drugs, is aimed at:

• removal of pain attacks;
• adjustment of protein metabolism;
• increase in the rate of formation and volume of urine;
• removal of inflammatory processes (if any).

To achieve these goals resort to antispasmodic drugs to relieve muscle tension in the urinary tract; uricostatic drugs are treated in violation of purine metabolism; to increase the volume of urine, diuretics are used and antibiotic therapy is prescribed for concomitant inflammatory processes.

Diet for stones

Adherence to the rules of a special diet is the main measure in the treatment of urate formation, regardless of what treatment is prescribed by the doctor. The diet promotes the dissolution of urate formations. Food should be taken in fractional portions in the amount of 4-6 meals per day. Be sure to include the following foods in your diet:

• dairy and sour-milk products;
• curd ingredients;
• hard cheeses;
• pasta;
• nuts;
• various fruits;
• seeds;
• cereals of wheat and buckwheat;
• foods high in vitamin C;
• watermelon fruits.

Food should be taken fractionally in the amount of 4-6 doses per day.

• legumes;
• bakery products (especially from higher wheat varieties);
• spinach;
• oxal greens;
• Luke;
• oatmeal;
• fish and seafood;
• spices;
• chocolate products;
• hot drinks (cocoa, tea, coffee);
• table salt.

Completely excluded foods:

• fatty meats and their by-products;
• rich broths from fish or meat;
• alcoholic drinks (beer, red wine).

Back to index

Surgery

Surgical intervention in the formation of urate stones is carried out in rare cases due to the fact that the urate component of the stones dissolves quickly, unlike stones of other compositions. The selection of the operation is strictly individual, depending on the age characteristics, overall indicators state, degree and stage of the disease in humans. They are mainly limited to the targeted elimination of the calculus without a deep impact on the organs. To date, the treatment of urate formations in the renal organs occurs mainly in inpatient departments through the introduction of new technologies for crushing stones with ultrasound.

Dissolution with the help of folk remedies

Such funds are unlikely to be able to dissolve stones. Alternative treatment in the form of the use of herbs and various components of plant origin are often prescribed in preventive measures. In complex treatment, common lingonberries, corn stigmas, common yarrow, knotweed grass, wild strawberries, horsetail, rose hips, bearberry leaves, parsley and white birch leaves are used. Therapy with the help of folk remedies is effective. In the dissolution of uric acid salts, special herbal preparations help, which include birch leaves, dill seeds, parsley fruits, horsetail, lingonberry and strawberry components.

Herbal infusions with a diuretic and anti-inflammatory effect are actively used in the treatment of stone formation. For such purposes, lingonberry leaves, horsetail, bearberry and half fell are suitable. Lingonberries are actively involved in the dissolution of urate stones and the removal of stone formation from the body. Also, the use of watermelon is very popular for urolithiasis due to its diuretic qualities and rich vitamin composition. The use of watermelon berries is allowed in unlimited quantities with small slices of black bread. Watermelon and bread should be consumed in the evening while taking a hot bath. This method helps to remove small stones and sand sediment. Most men swap watermelon for warm beer, which also has a diuretic effect, but does not have any beneficial properties.

Prevention

Preventive measures are of great importance. To prevent the re-formation of urate stones, a drinking regimen is prescribed to maintain the body's water balance in the norm. So, adults are recommended to drink from 1.5 liters of purified water in 24 hours. But for the accelerated removal of toxins, 2.5 liters of clean liquid should be consumed. Contraindications to abundant fluid intake are acute or chronic degrees of kidney failure, a person's tendency to edema, and problems in the cardiovascular system. A diet for urate stones is also recommended, namely: reducing the consumption of fatty, spicy, fried and salty foods and dishes with them. The intake of alkaline liquids (mineral water) is preferable, and the use of carbonated drinks with phosphoric acid is excluded.

Today, doctors diagnose urolithiasis in almost every second person. In their opinion, such sad statistics in most cases are explained by the deteriorating environmental situation, and in particular by the fact that we drink water of very poor quality. So, one of the factors that stimulate the occurrence of diseases of this kind are heavy metals present in the composition of drinking water, food and the air we breathe.

Urate kidney stones and their causes

The formation of uric acid stones in the kidneys is quite often a provoking factor in the development of various complications in other organs and systems of the human body. As a rule, uraturia occurs due to excessive accumulation of uric acid in the urinary organs, which, when decomposed, forms sand and small stones.

The production of uric acid is based on purine compounds, the source of which enters the body are certain foods. It is worth noting that purines play an important role in the structure of DNA and proteins, however, a violation of their metabolism often produces diseases such as urate kidney stones.

The main reasons for the formation of urate stones:

• violation of metabolic processes;
• low physical activity during the day;
• diseases of the digestive and genitourinary systems;
• abuse of spicy and sour foods;
• predisposition to this disease at the genetic level;
• disturbed water balance of the body. Excessive fluid loss can be caused by high fever, vomiting, strenuous exercise;
• poor blood flow to the kidney.

Fasting or excessive consumption of foods that supply purine substances to the body can also provoke the appearance of urate kidney stones, in particular:

1. Protein-containing foods: meat (especially fried), organ meats and broths, legumes, mushrooms.
2. Fish, including canned.
3. Tomatoes.
4. Alcoholic drinks.
5. Chocolate.

It is important to know that the likelihood of urate kidney stones is the same for both the male body and the female one. However, this problem can be encountered at any age.

Diet for urate kidney stones

The main task of the diet for this disease is to establish purine metabolism in the body by:

• exclusion of the consumption of products that violate the acid balance and contribute to the appearance of urates;
• alkalinization of urine, which will help remove stones from the kidneys;
• normalization of water balance in the body. It is recommended to drink about 2-3 liters of liquid during the day.

This task is perfectly handled by diet No. 6 from the official list of diets, which helps to reduce the burden on the urinary tract, normalize metabolic processes and prevent new formation of kidney stones.

Features of the diet in the fight against urates:

1. The rate of consumed calories increases - up to 2800 Kcal per day.
2. The basis of the diet is carbohydrates - about 400 grams per day. The amount of protein consumed is limited to 70-80 grams, fat - up to 90 grams per day.
3. You can not eat too cold food.
4. You need to eat often - five meals a day.
5. It is recommended from time to time to arrange fasting days for the body (for example, consume only one dairy food or only fruits during the day).

List of prohibited foods for urate kidney stones

Patients are prohibited from:

• meat (veal, lamb, pork and duck) and meat broths;
• meat by-products;
• fish and broths cooked on its basis;
• smoked meats and canned food, including vegetable pickles;
• any mushrooms, and broths prepared on their basis;
• legumes;
• vegetables and greens: lettuce, parsley, sorrel, spinach, celery stalks, tomatoes, radishes, asparagus and green beans, Brussels sprouts;
• fruits and berries with a high acid content, in particular: kiwi, pineapple, currants, cranberries;
• dried fruits;
• sweets: chocolate, sweets of any kind;
• drinks: strong tea, coffee, cocoa, alcohol;
• yeast and puff pastries and rye flour bread;
• soy sauce, mustard, horseradish.

During the diet, you should abandon fried, spicy and spicy foods. It is also recommended to limit salt intake.

Very often, patients are horrified by such a large list of restrictions, but do not worry, because there are also a huge number of permitted products.

According to the conditions of diet No. 6, with the deposition of urate stones in the kidneys, preference in nutrition should be given to dairy and vegetable products that have an alkalizing effect.

Products allowed for urate kidney stones

List of allowed products:

• sour-milk products: milk, cottage cheese (up to 500g), kefir, sour cream and butter in moderation;
• cereals and pasta;
• lean boiled meat (chicken and rabbit), but not more than once every two days;
• eggs - 1 pc. in a day;
• white and gray bread at least yesterday's preparation;
• dairy and vegetable soups without frying, you can add any cereals;
• boiled fish once a month;
• any nuts or seeds;
• any vegetables (with the exception of prohibited ones). Potatoes can be consumed, but in limited quantities;
• fruits and berries with low acid levels. It is recommended to give preference to apples, pears, grapes, watermelons, as they are the best help in alkalizing urine;
• citrus fruits can be included in the diet in the absence of oxalates in the urine, and if they are present, only oranges are allowed, but in limited quantities;
• sweets: honey, jam, marshmallow, marmalade.

Drinking with the deposition of urate stones:

1. Water:
   • therapeutic mineral water (“Borjomi”, “Essentuki No17”, “Polyana-Kvasova”, etc.). Alkaline mineral waters are excellent for dissolving stones. The norm per day is no more than half a liter. Water should be drunk in a warm form half an hour before a meal;
   • medicinal table water - up to 1-1.5 liters per day;
   • table water - can be consumed in unlimited quantities.

Important! In case of urolithiasis, the consumption of mineral water is carried out only under the supervision and prescription of the attending physician.

The drinking regimen of patients in whom the formation of urate stones occurs in combination with the development of other diseases (for example, arterial hypertension, renal failure, etc.) can only be established by the attending physician.

A few tips for cooking dietary meat dishes

As mentioned above, urate stones are formed with an excess of uric acid, the production of which is promoted by purine substances. Sources a large number these substances are: meat products and offal, fish and mushrooms.

It is worth noting that it is the cooking of these products that allows you to get rid of most of the purines contained in them, which, accordingly, remain in the broth. That is why it is strictly forbidden to use meat, fish and mushroom broths with urate kidney stones, and you can treat yourself to a delicious boiled piece of meat.

Tip #1 . Before you start cooking the meat, it should be soaked in saline for at least three hours.

Tip #2 . Soaked meat should be placed immediately in boiling water.

Tip #3 . When preparing first courses, meat should be cooked exclusively in a separate container and added to the plate already fully cooked.

Menu options for urate kidney stones

Menu option number 1

Breakfast- a soft-boiled egg, buckwheat porridge, a slice of slightly dried gray bread, a rosehip broth.

Lunch- two sweet apples.

Dinner- soup based on vegetables and pearl barley, pumpkin-curd casserole, compote.

afternoon tea- cabbage and carrot salad.

Dinner – bell peppers stuffed with a mixture of rice and vegetables, a glass of yogurt.

Menu option number 2

Breakfast- oatmeal with a handful of nuts, a glass of fruit jelly.

Dinner- vegetarian borsch with sour cream and breadcrumbs, cottage cheese with sweet berries and honey, green tea.

afternoon tea- Sweet fruit salad dressed with yogurt.

Dinner- vegetable stew, a glass of compote, an apple.

Menu option number 3

Breakfast- boiled egg, potato-zucchini pancakes, herbal tea.

Lunch- salad with cucumber, sweet pepper and green onion feathers.

Dinner- milk soup with pasta, cheesecakes on semolina, a glass of compote.

afternoon tea- bunch of grapes.

Dinner- boiled lean meat, vinaigrette salad, fruit tea.

Menu option number 4

Breakfast- milk rice porridge, croutons with jam, ginger tea.

Lunch- a pair of plums and a pear.

Dinner- vegetarian soup with vegetables, seasoned with sour cream, a glass of milk jelly and marmalade.

afternoon tea- fruit salad.

Dinner- boiled potatoes, cabbage and carrot salad, a slice of white bread, a glass of fermented baked milk.

Menu option number 5

Breakfast- an omelette from one egg, a salad of baked beets and walnuts, tea with milk.

Lunch- banana and pear.

Dinner- boiled chicken breast, rice and vegetable soup, pumpkin pancakes, a glass of compote.

afternoon tea- baked apple with honey.

Dinner- casserole of pasta, apples and cottage cheese, a glass of milk.

Konev Alexander, therapist

The description is up to date 10.12.2017

• Efficiency: therapeutic effect after 2 weeks
• Deadlines: constantly
• Products cost: 1300-1400 rub. in Week

General rules

Urolithiasis disease ( urolithiasis ) is a metabolic disease and is manifested by the formation of stones in any organs of the urinary system: kidneys, ureters or bladder. The likelihood of KSD in humans is increased by hormonal imbalance, hereditary metabolic disorders, nutrition of the patient, as well as existing anatomical abnormalities.

The development of stones is the result of the process of formation of the nucleus and the accumulation around it of constantly formed crystals. The formation of the nucleus occurs when crystals of various salts precipitate from urine supersaturated with them. The role of certain nanobacteria in this process has been proven. These atypical Gram-negative bacteria produce calcium carbonate on the surface of cells in the urinary system. Substances that keep salts in solution and prevent their precipitation include: sodium chloride , magnesium, zinc, manganese ions, hippuric acid , citrates, cobalt. Even in small amounts these substances inhibit crystallization.

The clinic of the disease is quite diverse. In some patients, it manifests itself as a single attack of renal colic, while in others it becomes protracted, an infection joins and various kidney diseases occur: hydronephrosis , pyelonephritis , pyonephrosis , sclerosis of the renal parenchyma and development kidney failure . The main symptoms of the disease are pain, the appearance of blood in the urine, urination disorders and the passage of stones and salt crystals.

Nutrition for nephrolithiasis will depend on the composition of the stones, and therefore may include mutually exclusive foods. Calcium is the basis of most urinary stones. The highest prevalence of calcium stones (including calcium oxalate and calcium phosphate), urate, consisting of salts of uric acid and magnesium containing, is noted. The oversaturation of urine with calcium and oxalate plays a major role in the formation of calcium oxalate.

Initial treatment for any type of KSD is aimed at increasing fluid intake, improving diuresis, changing diet, and controlling the acid-base balance of the urine. Kidney stone disease is a serious problem in urology, because despite the introduction of new, high-tech methods of therapy, there is a high frequency of recurrence of stone formation.

A rational diet restores normal metabolism and urine reaction, on which the possibility of the formation of calculi depends. In an acidic environment, urate stones are formed, oxalate - in a neutral acidic, and phosphate - in an alkaline. The right diet changes pH urine and serves as a criterion for the correctness of the diet. If the level pH in the morning 6.0-6.4, and in the evening 6.4-7.0, then the body is fine, since the optimal level is 6.4-6.5.

Treatment also depends on the composition of the stones and the acid-base state of the urine. "Sand in the kidneys" is expelled by abundant fluid intake and medicinal mineral waters, watermelon days and dietary recommendations. Decoctions of herbs (horsetail, lingonberry leaf, madder dye, goldenrod) and herbal preparations are widely used.

Yes, drug cystone promotes the removal of small oxalate, phosphate and urate stones. It is important that the litholytic effect of the drug does not depend on pH urine. It regulates the crystal-colloidal balance, reduces the concentration of oxalic acid and calcium in the urine. At the same time, it increases the level of elements that suppress stone formation (magnesium, sodium, potassium). As a result, it causes demineralization of stones.

An effective method for urate stones is descending litholysis (intake of drugs). For their dissolution it is necessary to create pH urine 6.2-6.8. This can be achieved by taking citrate mixtures: Blemarin And Uralit U . Treatment with citrate mixtures leads to complete dissolution within 2-3 months. Stones that are no more than one year old are better amenable to dissolution. Methods of contact dissolution of urate stones with the drug Trometamol . It is inserted through an established nephrostomy tube.

The dissolution of stones of a different composition is problematic and often ineffective, therefore, various methods of their prompt removal are resorted to. Open operations are now quite rare, since minimally invasive methods have appeared.

Applies extracorporeal shock wave lithotripsy , indications for it are almost all types of stones in patients of any age. Thanks to the use of remote lithotripsy, it became possible to remove calculi on an outpatient basis. The stone comes out in the form of destroyed fragments on its own, which can be complicated by blockage of the ureter and renal colic. Methods of "medium trauma" include transurethral endoscopic stone extraction .

It must be remembered that even surgical treatment is not a method of completely getting rid of the KSD and after crushing kidney stones, it is mandatory to prevent the recurrence of the disease. The complex of measures that correct metabolic disorders includes: antibacterial therapy, diet therapy, physiotherapy and spa treatment.

After removing stones from the kidneys, it is imperative to observe an adequate water regime (part of the liquid is taken in the form of cranberry or lingonberry fruit drinks and mineral water). Phytotherapy is of great importance. Herbal preparations are non-toxic and have a complex effect: antimicrobial, diuretic, litholytic, eliminate spasm and inflammation. These include the extract of madder dye, Cystenal , Kanefron , spilled , Phytolysin , Nephrolite .

Daily monitoring essential pH urine. At oxaluria prevention is aimed at alkalizing it, as well as eliminating oxalic acid from the diet. Uraturia also requires alkalinization of urine and restriction of protein foods rich in purine bases. With phosphaturia, acidification of the urine and restriction of calcium-containing foods are important.

For the sick oxalate urolithiasis treatment is recommended at the resorts: Zheleznovodsk, Pyatigorsk, Essentuki (No. 4, 17), Truskavets. With calcium phosphate - Pyatigorsk, Truskavets, Kislovodsk. With a therapeutic and prophylactic purpose, medicinal water can be drunk up to 0.5 liters per day, controlling urine parameters. The same recommendations apply to patients who have undergone removal of a stone from the ureter. Nutrition details will be discussed below.

diet for kidney stones

The nutrition of the patient does not depend on the location of the stones, but is completely determined by their composition and the reaction of the urine. The position of the stone determines only the clinic of the disease. With kidney stones (it is located in the pelvis), most often the outflow of urine is not disturbed and there may be no pain symptom. When a stone is in the ureter and while passing through it, a blockage of the lumen occurs and the outflow of urine is disturbed. This is accompanied by an attack of renal colic. There is a sharp, paroxysmal pain in the lumbar region. It can radiate to the testicle or labia, accompanied by vomiting and nausea. If the calculus is in the lower third of the ureter, there is a frequent urge to urinate.

Bladder stones are more common in older men. These are single round-shaped stones, and in composition they are urate. Their formation is facilitated by stagnation of urine in prostate adenoma. In other age groups, the causes are dietary habits, inflammation of the bladder, alcohol consumption, bladder diverticula, or the descent of a kidney stone. An effective and least traumatic method of treatment is endoscopic crushing ( cystolitholapaxia ) through the urethra.

Which diet will be prescribed in this case depends entirely on the composition of the stones. In a nutshell, with uric acid, you need to limit meat and eggs, soups with meat broths and sweet wines. With phosphates, the consumption of milk, eggs and all types of cabbage decreases, with oxalate - you can not eat radishes, onions, sorrel, spinach, legumes and tomatoes. This will be discussed in more detail below.

Diet for urate kidney stones (uraturia)

An indicator of the exchange of purines in the body is the concentration of uric acid in the blood. Purines are synthesized in the body and also come from food. The consequence of violations of this exchange is an increase in the level uric acid . Salts of uric acid found in urine are called urates.

The main reasons for its occurrence are:

• abuse of food rich in purines;
• abundance in the diet of high-calorie foods and fatty foods;
• malignant neoplasms;
• starvation;
• tissue destruction.

If there is an increased synthesis of uric acid, its level in the blood rises, and in parallel, crystals of its salts appear in the urine. Developing urate nephrolithiasis in young children, symptoms hyperuricemia manifested by pain in the muscles, arthralgia , tics, nocturnal enuresis, increased sweating , intoxication and asthenic syndrome.

At uraturia the nutrition of the patient should be aimed at reducing the level of uric acid. The diet is characterized by the restriction of products containing purines (meat, offal), oxalic acid (sorrel, radish, spinach, raspberries, cauliflower, asparagus, cranberries) salt. At the same time, the proportion of alkalizing foods (vegetables, milk, fruits) and the amount of liquid are increased in the diet.

With urates in the urine, it is necessary to exclude:

• Canned fish.
• Meat and poultry of young animals, offal, due to the high content of purines. It is limited to eat the meat of older animals - these dishes are included in the diet no more than 2 times a week. Servings of meat up to 150 g, and fish - 170 g.
• Meat broths, smoked meat dishes.
• Seedlings of cereals.
• Cheese, strong tea, chocolate, alcohol.
• Eggs, mushrooms, tomatoes, beans.
• Limit flour and various confectionery products.

The basis of the diet is milk, dairy products and vegetables, berries, fruits (seaweed, pumpkin, cabbage, grapes, apples, all citrus fruits, figs, bananas, raisins, currants, gooseberries, lingonberries, strawberries, cherries). Patients should periodically take courses in the use of diuretic herbs: clover, cornflower, burdock and dandelion roots, infusions of dried apricots, blueberries, stone fruits, apples, mountain ash, barberry, carrots, pumpkins, parsley root, beets. Contribute to the removal of stones, decoctions of grape leaves and black currant. In season, you need to use these berries as much as possible.

Culinary processing of meat and fish products has its own peculiarities - they must be boiled, and only then used to prepare various dishes. When cooking, 50% of the purines go away and should never be consumed. Meat, poultry or fish, devoid of part of the purines, can be stewed, baked, ground for minced meat or fried.

Grains are an essential part of the diet

The duration of such nutrition is from several months to permanent. The patient should drink 2.5 liters of liquid per day (alkaline mineral water Essentuki, Borjomi, natural juices) and spend fasting days once a week - kefir, curd, fruit, milk.

The main method of treatment and prevention of this type of stones is alkalinization of urine, since urates are poorly soluble in an acidic environment and easily turn into a solid form. enough to support pH at the level of 6-6.5. Citrate preparations are effective, which prevent crystallization and create conditions for the dissolution of already formed stones.

Phosphate in urine

Phosphates are phosphorus salts and are normally absent in the urine. Their presence may indicate the peculiarities of nutrition or pathology of the kidneys with a violation of their function. Urinary infection is one of the causes of stone formation. It is she who is an important local factor in maintaining the recurrent course of KSD. Thus, the metabolic products of microorganisms contribute to the alkalinization of urine and the formation of calcium phosphate crystals.

An increase in the level of phosphates is caused by the consumption of milk, kefir, cottage cheese, fish, seafood, fish roe, oatmeal, pearl barley and buckwheat porridge. The reason for the precipitation of these salts is the alkaline reaction of urine and the high content of calcium in it. The appearance of calcium phosphate stones is detected when hyperparathyroidism .

With phosphaturia, foods containing calcium and phosphorus are sharply limited. It is recommended to drink liquid up to 2-2.5 liters. In the presence of hypercalciuria appoint diphosphonates . You can increase the acidity of urine by drinking acidic juices and mineral waters Narzan, Darasun, Arzni, Smirnovskaya.

At pregnancy there is a secondary phosphaturia associated with a change in diet and alkalization of urine. If the urine becomes even slightly alkaline ( pH> 6.0), phosphate precipitates. This is facilitated by a diet rich in green vegetables and dairy products. It is necessary to repeat urine tests in dynamics, and only with re-identified changes, ultrasound and a more detailed examination of the kidneys are prescribed. Usually phosphaturia in pregnant women is corrected by diet.

Normal fluid intake (2 liters per day) is necessary, unless this is contraindicated due to the presence of edema and high blood pressure. From the diet are temporarily excluded:

• foods rich in calcium: dairy products, eggs, cocoa;
• salty and spicy foods (limiting salt to 8 g per day);
• garden greens (lettuce, green onions, dill, parsley, celery leaves and cilantro);
• potato;
• nuts, cocoa;
• sweet confectionery (biscuits, pastries, cakes);
• fruit juices;
• yeast.

Contribute to acidification of urine:

• meat and fish dishes;
• sour fruit drinks (from cranberries, currants, lingonberries);
• dried fruit compotes;
• Birch juice;
• cereal products;
• bran bread;
• the use of pumpkin, asparagus, Brussels sprouts.

Phosphaturia is quite common in children. Up to 5 years, these salts are present in the urine in the form of amorphous crystals, which give it a cloudy hue. Their appearance is associated with a large consumption of dairy products at this age. Often, crystalluria is transient and appears against the background of SARS and other diseases, disappears after the child recovers.

For more serious violations ( dysmetabolic nephropathies ) there is damage to the tubules of the kidneys due to metabolic disorders. Dysmetabolic nephropathies are characterized by supersaturation of urine and crystalluria.

True phosphaturia occurs in diseases that are accompanied by a violation of phosphorus and calcium metabolism in hypercalciuria . Crystals in this case are represented by calcium phosphate. Chronic infection of the urinary system is the cause of secondary phosphaturia. In this case, microorganisms with urease activity are of importance. They, decomposing urea, alkalinize urine, which leads to the formation of crystals of amorphous phosphates (magnesium phosphate salts).

With amorphous phosphates in the urine (they do not have a clear structure), we can recommend taking decoctions of lingonberry leaves, bearberry, knotweed, horsetail. It must be remembered that in an alkaline environment, the solubility of phosphates decreases. In this state, assigned Diet number 14 , changing acid-base balance in the direction of acidity.

Oxalates in urine

Calcium oxalate salts are leading place by occurrence. This kind of stones appears with a diet rich in oxalic acid salts. However, there may be a congenital disorder of oxalic acid metabolism ( dysmetabolic nephropathy ). Another reason for the formation of these stones in the urine is an increase in intestinal permeability to oxalo-acetic acid (it is absorbed from the intestines and enters the urine) and calcium deficiency, which normally binds oxalates in the intestines. The increased formation of oxalates is also explained by the use of a large amount ascorbic acid - it is metabolized to oxalic acid. The process of formation of poorly soluble calcium oxalate in the body occurs most actively with a lack of magnesium and vitamin B6 .

Taking into account all these points, adjustments are made to the diet:

• Foods high in oxalic acid are excluded: rhubarb, figs, sorrel, spinach, beans, chocolate, parsley, celery. A moderate content of this acid is found in tea, chicory, carrots, green beans, onions, beets, tomatoes, plums, strawberries, gooseberries.
• The use is limited vitamin C with products: grapefruit, strawberries, lemons, sea buckthorn, gooseberries, currants, oranges, tangerines, rose hips, cranberries, mountain ash, wild strawberries, wild garlic, bell peppers.
• Introduced a large number of vegetable fiber.
• A plentiful drinking regimen is observed, which prevents the precipitation of calcium oxalates (3 liters per day). Water is alternated with the use of juices (cucumber and other fruit and vegetable), compotes, fruit and vegetable broths. Weak solutions of organic acids (malic, citric, benzoic and others) contained in them can dissolve oxalates.
• Alkalization of urine is carried out by using mineral waters: Naftusya, Essentuki No. 4 and No. 20, Truskavetska, Luzhanska, Morshinska, Berezovskaya.
• Oxalates are removed from the peel of apples, pears and quince, birch leaves, elder flowers, violet roots.

Diet for urolithiasis in women

In women, severe forms are more common, for example, staghorn nephrolithiasis . With coral stones foreign body occupies almost the entire cavitary system of the kidney. With this severe form of KSD, only open surgery is performed. A common cause of it is hyperparathyroidism (increased function of the parathyroid glands). Thanks to modern diagnostics, such neglected forms have recently become less common.

The growth of urolithiasis is provoked by: the nature of nutrition (an abundance of protein in the diet), physical inactivity, which leads to a violation of phosphorus-calcium metabolism. An unbalanced diet aggravates the situation. For example, a bias towards protein foods with frequent adherence to a protein diet provokes the formation of urate stones. With sand in the kidneys, attention should be paid to nutrition and the reaction of urine, since this condition is reversible and can be corrected by nutrition and abundant fluid intake. You can periodically take diuretic fees. For urolithiasis in women, the general dietary recommendations described above should be followed, as they do not differ.

For women it is also important:

• fight hypodynamia and lead active image life;
• prevent weight gain;
• drink enough liquid;
• do not overcool and treat inflammatory diseases of the urogenital area in time.

All these factors contribute to stone formation.

With pyelonephritis and urolithiasis

In this case, a more rigorous approach to treatment and therapeutic nutrition is needed. Pyelonephritis is often a complication of KSD. Antibacterial therapy is mandatory based on the results of the sensitivity of pathogens to antibacterial drugs. In parallel appointed herbal preparations (Phytolysin , Kanefron , spilled ). It must be remembered that only the removal of the stone creates the conditions for the complete elimination of the infection.

Patients are shown Table number 7 , in which a correction is carried out taking into account the composition of stones. In the presence of inflammation, diet therapy is aimed at sparing the kidneys, so it is forbidden to use: seasonings, pickles, spicy foods, smoked meats, marinades, horseradish, mustard, vinegar, fish roe, onions, garlic, alcoholic beverages.

Nutritional features are a significant restriction of salt (1.5 g-5 g), depending on the state of kidney function. It is not allowed to take sodium (salt) medicinal waters.

Approved Products

• Any vegetables, except for legumes and with a high content of oxalic acid. Eggplants, sweet peppers, potatoes, tomatoes, cucumbers. Vegetables should be eaten raw before meals whenever possible.
• Enrich the diet with foods rich in vitamin A (broccoli, sour cream, seaweed and other algae) and group B (nuts, corn, rose hips, oatmeal, barley groats, white cabbage, pomegranate, bell pepper, oranges, grapefruits).
• Fruits with a high content of vitamin C: sea buckthorn, rose hips, lemon, currants, kiwi, citrus fruits, strawberries, wild strawberries, grape juice.
• Any cereal.
• Milk, cheese, cottage cheese, eggs butter.
• Any bread - rye, bran and wheat. It is better to use yeast-free pastries.
• Lean meat and fish dishes can be eaten no more than 3 times a week. When choosing meat, keep in mind that chicken legs have a higher content of purines than breasts, just like pork legs. There are 4.5 times less purines in turkey meat than in chicken. All meat or fish dishes are pre-boiled to reduce the content of purines, and then they are cooked at their discretion: baked, fried or stewed.
• Vegetarian vegetable and cereal soups.
• Two eggs a day, protein omelettes - protein does not contain purines.
• From sweets - marmalade, jam, sugar, honey, caramel, marshmallows, marshmallow. Excludes chocolate.
• Before going to bed, drink 1 glass of liquid (bran decoction, juices, water with lemon or other citrus fruits, herbal tea, kefir).

At oxalaturia :

• A milk-vegetable ("alkaline") diet is observed. Regular consumption of foods rich in calcium is recommended - dairy products (sour cream, sour-milk products, cottage cheese).
• To lower the level, you need to eat foods rich in vitamins B1 And AT 6 . These are eggs, meat, liver. Fish, meat and poultry should be lean varieties (boiled or baked).
• Wheat and rye bread.
• All cereals.
• Vegetable oil and butter.
• The diet is enriched with foods rich in magnesium: oatmeal, buckwheat, pearl barley, wheat bran, seafood, seaweed, wholemeal bread, dried apricots, oatmeal, peas, soybeans, radish. Magnesium ions bind up to 40% oxalic acid in the urine with the formation magnesium oxalates which dissolve well. Magnesium deficiency is manifested by the formation calcium oxalate .
• Cauliflower and white cabbage, potatoes in any form, eggplant (in moderation), carrots, pumpkin, cucumbers, cilantro greens.
• Apricots, bananas, pears, prunes, grapes, apricots, apples, watermelons, melon, peaches, quince, dogwood. The removal of oxalates is facilitated by apples, pears, quince, decoctions of currant leaves, pears and grapes, as well as decoctions of fruit peel. To alkalize urine, you need to eat dried fruits.

At phosphaturia nutrition is shown with a predominance of meat food and flour dishes:

• Any fish, non-spicy fish snacks, soaked herring, as well as in a small amount and infrequently - canned fish.
• Meat, poultry in any preparation.
• Pasta and unleavened dough dishes.
• Any bread and flour products.
• Soups on a weak broth with cereals, pasta, egg dressing.
• Fats other than refractory.
• Diet Enrichment vitamin A : liver of animals, birds, liver of cod and halibut, fish caviar, butter.
• Introduction of an additional amount vitamin D : tuna, salmon, pink salmon, fish roe.
• From dairy products, only sour cream in a small amount for dressing.
• A variety of porridges cooked in water.
• One egg per day.
• Vegetables are excluded, but you can pumpkin, green peas, Brussels sprouts and mushrooms, vegetable juices are excluded.
• Sour varieties of apples, compotes, jelly from them, cranberries, lingonberries, red currants.
• You can drink weak tea and coffee, but without milk, fruit drinks from cranberries and lingonberries, rosehip broth, bread kvass.
• Confectionery, sugar, jam and honey.

Wholly or partially restricted products

Nutrition for kidney stones caused by salts urates should not contain:

• Offal.
• Meat products and canned meat. Animal protein is limited. Red meat from young animals is excluded because it contains the largest number purines.
• Dishes from carp, halibut, sardines, tuna, sea bass, mussels and herring, the use of canned fish is excluded.
• Any broths - in rare cases, a secondary broth can be used.
• Beef and pork fat.
• Vegetables rich in oxalic acid (radishes, spinach, cauliflower, sorrel, asparagus, cranberries, raspberries) and pickled vegetables.
• Spinach, sorrel and legume soups.
• Legumes and mushrooms (porcini and champignons).
• Oatmeal and white rice.
• Cheeses, chocolate, cocoa, red wine, tea and coffee are also rich in purines.
• Confectionery, brewer's yeast.
• Spicy appetizers and spices.
• Dried fruits (prunes can be).
• Alcohol.

At oxalaturia excluded or limited to:

• Products with oxalic acid.
• Jelly and gelatin-containing dishes.
• Sprouted cereals.
• Fatty meats and fish. Lean meat and fish dishes can be up to 150 g per day.
• Soups cooked in strong broths and containing legumes.
• Cocoa, bread kvass, coffee, chocolate.
• Limit the use of potatoes, beets, tomatoes, onions, carrots, eggplants, zucchini, Brussels sprouts, legumes, tomatoes and tomato juice, celery, parsley, rhubarb.
• Salted cheeses, canned food, smoked meats.
• Limiting milk intake and fermented milk products.
• Sweet pastry products.
• Foods with vitamin C are reduced: lemon, grapefruit, currants, rose hips, oranges, mountain ash, strawberries, gooseberries, Antonov apples, cranberries, tangerines, dill, wild garlic, sweet peppers.
• Restriction of salt to 3-4 g.

• Calcium-containing foods (milk, cottage cheese, cheese), sesame seeds.
• Greens and vegetables (you can Brussels sprouts and peas).
• Spicy dishes, smoked meats, sauces.
• Nuts, cocoa.
• Alcohol.
• Sweet yeast bread.

Diet menu for kidney stones (Diet)

As can be seen from the list of allowed products, it is difficult to create a universal menu for different types nephrolithiasis , since products that are allowed in one case are contraindicated in another. So at oxalate nephrolithiasis vegetable and meat nutrition urate - vegetable and dairy, and with phosphaturia on the contrary, meat food should prevail. The issue of compiling a diet in each case is decided individually, and the doctor gives recommendations on nutrition.

Most often at this age, calcium oxalates and phosphates are detected, less often urate stones and extremely rarely cystine stones. Salts of oxalates, urates and phosphates can appear periodically and depend on fluctuations in the diet, and the presence of cystine is a sign of pathology.

Nutrition with salts in the urine in children of different ages does not differ from that in adults.

At oxalate crystalluria a potato-cabbage diet is prescribed. It is necessary to exclude extractive meat dishes, as well as cranberries, beets, carrots, sorrel, spinach, cocoa, and chocolate rich in oxalates. "Alkaline" effect is provided by prunes, dried apricots and pears. Of the mineral waters, Slavyanovskaya and Smirnovskaya are used in monthly courses 2-3 times a year. In addition to diet therapy for oxalate stones, it is used Vitamin B6 , magnesium preparations and Fitin .

Treatment phosphate crystalluria aimed at acidifying the urine. For this purpose, mineral waters are used: Dzau-suar, Narzan, Arzni and preparations: methionine , cystenal , ascorbic acid . Food is prescribed with a restriction of foods with phosphorus (legumes, chocolate, cheese, dairy products, liver, fish roe, chicken). If there is a large amount of calcium phosphate in the urine, it is necessary to reduce the absorption of phosphorus and calcium in the intestine by prescribing Almagel . In the presence of tripelphosphates antibiotic therapy and uroantiseptics for the purpose of sanitation of the urinary system.

During treatment urate crystalluria the nutrition of the child provides for the exclusion of purine bases. These are the following products: meat broths, liver, kidneys, nuts, peas, beans, cocoa. Preference is given to products of dairy and vegetable origin. It is important to drink 1-2 liters of fluid. These should be slightly alkaline mineral waters, decoction of oats and decoctions of herbs (dill, horsetail, lingonberry leaf, birch leaf, clover, knotweed). For supporting pH urine use citrate mixtures ( Magurlit , Uralit-U , blemarin , salt water ).

Stone formation in a child is provoked by conditions that lead to permanent obstruction of the urinary tract: anomalies in development and position, endocrinopathy ( hyperparathyroidism , hyperthyroidism , infant hypercalcemia ) acquired tubulopathies and chronic urinary infection. Of course, it is important to eliminate the main cause of stone formation.

In contact with

They are second in prevalence to oxalate stones and occur in people aged 20 to 50 years.

What are these formations and what do they look like?

Urate stones are formed with an increased concentration of uric acid salts in organism. Moreover, salts can accumulate both in the kidneys and in.

Salts are not completely eliminated from the body, but they can be corrected by eating fermented milk products. In this case urine becomes more alkaline, which prevents the appearance of urates.

At present, it is possible to prevent the appearance of urates.

So, an hour before meals, a pH test should be carried out using special strips. pH level below 5.5 speaks of the possible formation of calculi.

If treatment is not started on time, there is a possibility that urate stones will be converted into coral-like ones. And this, in turn, can lead to or even kidney failure.

What is kidney failure read in our article.

Symptoms of stones

Symptoms of the manifestation of the disease always appear unexpectedly. The main signs of urates:

If any of these symptoms appear, contact a specialist immediately!

What methods are used to detect them?

The most common method for diagnosing the presence of stone formations in the kidneys is. It clearly shows the size and location of the stone. The only drawback of this method is that it is impossible to determine by ultrasound whether it is a urate stone or some other. That's why a number of additional studies are assigned:

It should be noted that 100% chemical analysis of the stone can only be done after his departure or removal.

How are they treated?

Urate stones, unlike others, are amenable to dissolution.

Doctors prescribe special medications for this. Along with them, you should follow a diet, use diuretic decoctions of herbs. Required condition: plentiful alkaline drink.

If the stones are not very large, you can try to remove them yourself, without surgery.

Important: any manipulations should be carried out only under the supervision of the attending physician!

He will prescribe special medicines and diuretic decoctions. At the same time, it is necessary constant monitoring of the situation with the help of ultrasound.

If the stone has moved, and it is impossible to remove it on its own, and there is no time for dissolution, doctors recommend crushing. It is carried out by exposure to ultrasonic waves or a laser beam on the stone. It is used for formations of large sizes.

The method does not cause complications, but there are contraindications:

1. pregnancy;
2. large weight (more than 180 kg);
3. kidney tumor, etc.

And finally, the most radical method of dealing with urolithiasis is surgical intervention. A small incision is made in the lumbar region and the stone is removed. It should be noted that before the operation it comes in 20% of cases. Usually it is possible to cope with the calculus in the first two ways.

How and with what to dissolve urate?

If urate is found, you can try to dissolve it. But, only on condition that renal colic has not yet begun and the stone has not started its movement. To dissolve:

It should be noted that the process can stretch for a period of 2 months to six months.

Folk methods of treatment

Traditional medicine advises decoctions of herbs to remove stones. Thus, the most common method is rosehip root decoction: 2 tbsp. l. dry roots pour a glass of water, and boil for 25 minutes. Then the broth should be set aside from the stove and let it brew for another hour. It should darken.

After that, the broth should be filtered and taken 1/3 cup 3 times a day before meals for 2 weeks.

Another good diuretic that fights urates is the grass is half fallen. A glass of boiling water pour 2 tbsp. dry grass and pour it all into a thermos. Leave to infuse for 1 hour. Important: every day you should prepare a fresh portion of the infusion! Take 3 times a day for 25 minutes. half a cup before meals. The course of treatment lasts from 10 to 30 days.

Do not self-medicate without the involvement of a doctor! It can be hazardous to health!

Learn how to remove stones from the kidneys from the video:

Urolithiasis today is not a single diagnosis. meager physical activity, food from fast foods - these are the main reasons for the appearance of various types of formations in the kidneys.

Depending on the individual characteristics of the body, genetic predisposition, as well as the daily diet, the type of stones in the urinary system differs.

How urate stones appear

Urate kidney stones are diagnosed quite often in people in the age group from 25 to 50 years. In half of the cases, this pathology is accompanied by complications of various types.

Urate-type kidney stones are not uncommon. These formations are almost entirely composed of uric acid salts (urates). Salts, namely an increased concentration of substances, accumulate not only in the kidneys, but also in the bladder. And if a person does not correct his diet, then these salts will be converted into urate stones.

The size of stones of this type directly depends on the stage of development of the disease. Their surface is smooth, yellow, with a characteristic brick shade; and the texture of the stone itself is loose, heterogeneous.

That is why they are quite easy to crush or dissolve when using appropriate medications.

Doctors identify several possible causes of urate stone formations at once:

1. The root cause of this type of stones in the kidneys and bladder of the patient is the high concentration of pH in the urine. To determine the degree of concentration of these salts, it is not necessary to carry urine to laboratory analysis. You can use special test tapes for home determination of the concentration of salts in the urine. However, even with a small content of these substances in the body, stones of this type can form if there is a genetic predisposition. But it will not be possible to completely eliminate salts of uric acid from urine.
2. Unfavorable working conditions.
3. hereditary factor. The predisposition to the formation of KSD can be laid down at the genetic level and transmitted from generation to generation.
4. An increase in salt concentration also occurs due to a violation of the metabolic nature, which leads to a natural imbalance and precipitation of salts.
5. The place of residence is also important. Depending on the geography of residence in some places, people are more likely to be at risk of developing urolithiasis.
6. If a person's kidneys do not produce urine at an insufficient rate.
7. Flaw physical activity together with malnutrition, not only provokes the appearance of formations of this type, but also causes their intensive growth.
8. Analgesics and insufficient intake of B vitamins are other common causes of urate stones in the urinary system of the body.

Urinary reaction can be measured using special test strips. Acidity rate - indicators from 6 to 7 units. It is worth considering that evening urine is less acidic than morning urine. If the level of acidity in the body is always above 5., urate stones do not form at all.

Symptoms of pathology

In most cases, kidney stones form and grow asymptomatically. Most patients learn about their presence in the body after the manifestation of renal colic. Renal colic is manifested if the urate stone reaches a rather impressive size and interferes with the normal outflow of urine.

The main symptoms are manifested in sudden acute pain in the lumbar region, which very quickly spreads to the abdomen, genitals. This pain is accompanied by a feeling of chills, nausea and vomiting. If renal colic is accompanied elevated temperature bodies - this is a clear sign that an inflammatory process has begun in the kidneys against the background of the KSD. The causes of inflammation can be different, but the main one is the stagnation of urine, which is an excellent environment for the development of bacteria.

Urates, even before the onset of renal colic, can show symptoms such as constant aching pain in the lower back, problems with urination (depending on the location of the stones).

Symptoms indicating the existence of renal stone neoplasms:

• unilateral sudden low back pain;
• pain radiating to the abdomen and bladder, as well as the genitals (the pain is practically intractable, it is impossible to find a position to relieve pain);
• nausea and vomiting;
• chills develop;
• flatulence develops;
• fever (rare) - very danger sign, which indicates the onset of renal inflammation;
• pain when urinating;
• cloudy urine (sometimes with grains of sand or stones).

Diagnosis of urates

To diagnose urate kidney stones, doctors use a comprehensive study. So, if the patient came with symptoms that clearly indicate the presence of kidney stones, an ultrasound examination is mandatory. According to the results of ultrasound, it will be possible to determine their size and location.

Increasingly, for the diagnosis of urate kidney stones, more modern methods- Computed tomography and MRI. If it is not possible to conduct examinations for the presence of urates through the use of these devices, then they can be diagnosed using an X-ray examination.

However, contrast is injected into the kidneys before the scan through the urinary canals, since the usual X-ray examination does not show the presence of urate stones (they are not visible).

Diagnostic measures for the detection of ICD and the establishment of chem. composition of stones:

• advanced analysis of urine and blood;
• retrograde pyelography;
• renal examination using ultrasound and magnetic resonance imaging;
• urography;
• kidney urography (intravenous);
• CT scan;
• renal radiography with the use of contrast agents.

Methods of treatment

There are several methods of treatment:

1. Dissolution. Urate stones are one of the few formations in the kidneys that respond well to dissolution with the use of special medicines, medicinal decoctions and diet. However, this is only possible if timely diagnosis urates (25-30% of all cases). If the stones are small, they can be removed from the body by relaxing in specialized resorts. But you should not take an independent initiative, only a doctor should recommend such treatment.
2. Splitting up. This method of treating urate stones, which have reached an impressive size, has been successfully practiced for the past few years. Crushing of the stone occurs by influencing the formation of ultrasonic waves. This method does not cause complications and does not require a long rehabilitation period as in the case of standard surgery. However, there are reasons why crushing kidney stones may be contraindicated. First of all, it is pregnancy, overweight (over 180 kg), tumor formations in the kidneys and some other reasons.
3. Operational intervention. Recently, this method is used only as a last resort, if it is impossible to carry out treatment with the first two methods, or if the therapy has not given the expected result. Today, surgery to remove urates is reduced to making a small incision in the lumbar region. And standard operations with an opening of the abdominal cavity are used only if the entire kidney needs to be removed.

On initial stage The treatment of urates may differ from that of other types of stones. Sometimes, in order to eliminate stones, you just need to increase the amount of water consumed and start an alkalizing process that leads to an increase in pH. In this situation, invasive interventions are not needed.

Therapy with medications is mainly drugs that relieve pain and lower the pH level. If infections are detected, treatment is supplemented with antibiotics. Urate stones are treated better than other types, but their dissolution should be carried out exclusively under the supervision of an experienced urologist.

The intervention of surgeons can be prescribed only in the most advanced cases, taking into account the age of the patient and his state of health. An experienced surgeon will be able to remove stones with little or no impact on the kidney. The process of ultrasonic crushing of stones can also be performed.

Proper nutrition and traditional medicine

For a long time, decoctions of medicinal plants have been used to treat urate stone formations in the kidneys; today, their use also provokes a more rapid dissolution of urate stones. To prevent the appearance of formations of this type, it is recommended to drink decoctions of rose hips, berries and leaves of strawberries, leaves and birch buds.

But if the stones have already formed, in order to accelerate their dissolution, it is necessary to take decoctions of special medicinal preparations. A decoction of walnut leaves, omentum and wheatgrass roots, juniper fruits and golden rod grass copes well with this task.

All components are taken in equal parts, and for the preparation of infusion 1 tbsp. collection poured 200 gr. water and infused for 30 minutes. You can take such a decoction instead of tea twice a day - in the morning and in the evening.

In the formation of urate stones, in addition to the main method of therapy, it is strongly recommended to follow a special dietary diet. The diet for urates in the kidneys and bladder is quite diverse, so the patient will be able to fully enjoy food if he correctly composes a menu of allowed foods.

There is also a rather impressive list of foods that you should definitely completely eliminate from your diet. These are meat broths, pickles and marinated products, sausages, mushrooms, chocolate, cocoa, fish and fish broths, alcoholic drinks, tea, coffee.

Urolithiasis is caused by the appearance of stones in urinary tract. By chemical nature, urinary stones can be different, and the choice of treatment method depends on this. Today we are talking about the case when urate stones in the kidneys and their dissolution and diet during treatment will be considered.

Urate stones - general information

Urate stones are made up of insoluble uric acid salts. They are usually found in representatives of the strong half of humanity. They can be found in the renal pelvis, ureters, and bladder.

The color of calculi (stones) is most often yellow-brown. The formations are characterized by a smooth, even surface and therefore can often come out on their own. The formation of stones requires an acidic environment in the urine.

Treatment, general principles

The treatment of urolithiasis is based on the elimination of factors that contribute to further stone formation, as well as the formation of prerequisites for the dissolution of already formed stones.

Since the formation of urate stones requires increased acidity of urine, it is necessary to take all measures aimed at alkalizing this biological environment. At the same time, it is not only possible to get rid of small stones and reduce the likelihood of further progression of the disease.

Medical therapy

Treatment of urolithiasis is reduced to taking medicines included in the following groups: antispasmodics, painkillers, anti-inflammatory drugs, diuretic drugs. The mentioned groups of drugs are not specific for urates, but are used to treat any form of urolithiasis.

Diet for urate stones

Patients, in the absence of contraindications, are advised to consume as much liquid as possible. With an increase in the amount of urine, it will dilute, which will lead to the normalization of the acid index and a decrease in the concentration of uric acid and calcium.

Small stones, which are only a few millimeters in size, can dissolve even with the simple use of large amounts of water. This type of therapeutic effect is effective only in the presence of urate stones. For oxalates or other urinary stones, the amount of fluid consumed does not pay much attention.

Traditionally recommended for urolithiasis juices and cranberry fruit drinks, it is better not to use at all. The citric acid contained in them, although it reduces the intensity of calcium absorption reactions from the intestines, can lead to acidification of the body and the appearance of stomach ulcers.

Regarding nutrition, there are also several recommendations. Foods that contribute to acidification of urine should be excluded from the diet: onions, garlic, sorrel, oatmeal, fish and all seafood, chocolate, coffee, tea, salt, legumes, alcoholic beverages, especially colored ones, for example, beer, cognac, wine.

List of recommended products: non-acid fruits, buckwheat, chicken eggs, dairy products, pasta, cheeses, cottage cheese, watermelons, nuts. In addition, it is recommended to take food 4-6 times a day. A properly selected diet for stones will reduce the intensity of stone formation processes, but will not have a noticeable effect on already formed stones.

Folk methods of treatment

In the treatment of urolithiasis, it is very important not to self-medicate, even if we are talking about time-tested folk methods. Any therapeutic effect on the body should be agreed with your doctor.

Each collection includes at least 5 different herbs. For example, kidney collection No. 1 has the following composition: linden flowers, willow bark, rose hips, parsley fruits, black elderberry flowers, chestnut flowers.

The dosage of drugs is prescribed by a specialist. As a rule, during periods of exacerbation of the disease, medicinal preparations are used more often, for example, 4 times a day, and during remission (feeling better), it is recommended to use infusions no more than 1-2 times.

Features of medical tactics

If conservative therapy does not improve the condition, as a rule, other types of treatment are resorted to. IN last years non-contact methods of destruction of calculi have become very popular, in which the stones are exposed to ultrasound, which leads to their destruction and removal in a natural way.

In addition, a contact effect on urate stones is also possible. This type of treatment is often used if the stones are in the bladder. Through the urethra, high-tech equipment is introduced, with the help of which the destruction of stones is carried out.

Abdominal surgery for urolithiasis is currently used extremely rarely. Such types of treatment are very traumatic and quite dangerous. After such operations, there is a high probability of infectious complications, and the duration of the rehabilitation period can be measured in several months. Moreover, the operation does not eliminate the prerequisites for stone formation at all.

Currently, the incidence of urolithiasis () among the population of our country, according to medical statistics, reaches 20-30%, which experts attribute to the deterioration in the quality of drinking water and the unfavorable environmental situation in general. One of the significant exogenous factors is an excess of heavy metal compounds (in particular, lead), the accumulation of which in the body inevitably leads to various metabolic disorders.

Causes of kidney stones

With urolithiasis, urate kidney stones often form. In terms of frequency of occurrence, calculi of this composition occupy the next place after the most common. Most often they are diagnosed in young and mature patients (from 20 to 50 years). In the elderly and in patients childhood deposits often occur in the bladder. In many cases, the first signs of the development of the disease are intense pain.

Urate stones are formed from uric acid salts against the background of their increased concentration. The direct reasons for the formation of calculi include low pH (acidic reaction) of urine and a slowdown in its formation.

note: now it is possible to timely detect an increased likelihood of developing a pathology by regularly determining the reaction of urine an hour before a meal using test strips.

Uric acid compounds (urates) are derivatives of the normal metabolism of protein compounds, therefore they are always present in the body in a certain amount, and it is not possible to completely get rid of them. You can prevent the formation of urate stones and sand in the kidneys by eating foods that shift the pH of urine to the alkaline side.

Important:normal urine has an alkaline reaction (6.0-7.0). At pH levels above 5.5 (neutral), the likelihood of urate formation is low.

If the formation of urine proceeds at an insufficient rate, then its concentration and the percentage of urates in it increase. As a result, salts precipitate, gradually forming a dense formation. In such situations, the degree of acidification of urine can be reduced by consuming a large amount of fluid (at least one and a half liters per day, and in hot weather - at least two).

Factors predisposing to the formation of urate deposits include:

• physical inactivity (a sedentary lifestyle);
• starvation;
• the use of certain analgesics in dosages exceeding those recommended;
• lack of B vitamins;
• irrational nutrition (in particular, the consumption of animal protein in large quantities).

note: physical inactivity leads to disruption of various metabolic processes, in particular - the metabolism of phosphorus and calcium.

Specific features of urate kidney stones

Urate deposits are usually round and smooth in shape. The size of stones can vary from 1-2 mm to several centimeters. Urate is characterized by a yellow-brown color and a rather loose structure.

Clinical picture

Urate stones may not make themselves felt for a long time. Symptoms in most cases develop unexpectedly.

The patient develops renal colic with characteristic signs:

• intense (as a rule - unilateral, from the side of the affected organ, but "girdle" is not excluded);
• pain "gives" to the abdominal region (stomach), bladder and genitals;
• pain syndrome is almost impossible to remove;
• the patient has chills;
• changing posture does not bring relief;
• in some cases, there are dyspeptic disorders (nausea, vomiting).

Important:hyperthermia (increased overall body temperature) against the background of colic with a high degree of probability indicates the development of an acute inflammatory process in the tissues of the kidney.

The cause of renal colic is an obstruction (blockage) of the urinary tract with a stone, which prevents the passage of urine.

One of the possible symptoms may be gross hematuria, i.e. the presence of blood in the urine.

Possible Complications

The progression of the pathological process can lead to the transformation of deposits into the so-called. coral-like stones that fill a significant volume of the kidney.

As a result, it is possible to develop an acute inflammatory process in the renal pelvis () and.

Diagnostics

Urate stones are more commonly found in male patients. This is due to the fact that many men prefer meat products, and consume relatively little fruit, vegetables and dairy products.

Excess uric acid not only leads to the formation of urates, but also causes gout (develops with the deposition of uric acid salts in the joints). The incidence of gout is also higher among men.

Note:in women, severe forms of urate nephrolithiasis are more common - large staghorn formations.

To identify the nature of the pathology is usually not enough history data.

Diagnosis of urate stones includes:

• deep laboratory research the patient's urine;
• carrying out survey and excretory urography;
• Ultrasound of the kidneys;
• spiral CT ();
• MRI (magnetic resonance imaging);
• contrast fluoroscopy.

note: conventional X-ray examination in most cases is not very informative.

When making a diagnosis and subsequent choice of treatment tactics, it is necessary to take into account the presence concomitant diseases, such as:

• cardiac ischemia;
• gout.

Treatment for kidney stones

Therapy for urate deposits is different from the treatment process for other types of stones.

General principles of conservative treatment

One of the specific features of urates is their relatively easy dissolution, therefore, in most cases, conservative measures can achieve a positive effect.

The dissolution of urate kidney stones involves the consumption of large volumes of fluid in order to shift its pH to the alkaline side. In addition, the patient is shown a diet in which the diet should include a large amount of dairy and vegetable foods (such products contribute to the alkalinization of urine). Alkaline mineral waters are shown.

Alternative treatment of kidney stones

Diuretic herbs include horsetail and bearberry. An effective diuretic is also a decoction of lingonberry leaves.

diet for kidney stones

Compliance with a special diet is considered as one of the main ways to dissolve urate stones in the kidneys and ureter.

Foods and drinks that should be excluded from the diet:

• fatty pork and beef;
• animal products rich in purine bases (liver, kidney, veal);
• fish and meat broths;
• offal;
• canned food;
• red wine;
• beer.

Foods that should be reduced:

• legumes (, peas,);
• bakery products (especially from higher grades of wheat);
• Fish and seafood;
• spices;
• chocolate and cocoa;
• strong tea.

Foods that must be included in the diet to remove urate stones from the kidneys:

• eggs;
• milk and sour milk drinks;
• cottage cheese;
• pasta;
• any fruit;
• seeds;
• wheat and buckwheat;
• foods rich in ascorbic acid (rose hips, etc.);

note:for treatment and prevention, fractional nutrition is indicated, which involves eating in small portions 5-6 times a day.

Treatment of urate kidney stones with pills

Acute symptoms can reduce antispasmodics and anti-inflammatory drugs. Antispasmodic drugs relax the smooth muscles of the urinary tract, one hundred helps to reduce obstruction of the duct and accelerate the removal of stones and sand in a natural way.

If violations of purine metabolism are detected, drugs from the group of uricostatics (Allopurinol) are prescribed. The presence in the urine of high concentrations of urates and oxalates is an indication for the use of magnesium oxide, and if there is a high content of calcium salts, Hypothiazide is prescribed (standard dosages).

Patients are shown taking the so-called. "citrate mixtures" to alkalinize urine and maintain its pH in the range of values ​​​​from 6.2 to 6.8.

Surgery

To remove stones from the kidneys, surgery may be a necessary measure, which is resorted to in 3-5% of cases. Surgical intervention is necessary if there are large staghorn formations. Crushing of kidney stones by ultrasound and laser (lithotripsy) is also used relatively rarely.

With urate kidney stones, the size of which does not exceed 2.5 cm, minimally invasive remote lithotripsy is successfully used to destroy the calculus.

Prevention

It is not enough to know how to remove stones from the kidneys; you need to have a good idea of ​​how to prevent a relapse of the disease. The re-formation of urate calculi prevents compliance with the drinking regimen. For the normal course of metabolic processes, an adult needs to drink at least one and a half liters of liquid per day (preferably clean water). However, to accelerate the elimination of toxic metabolic products, i.e., to cleanse the body of toxins, about two and a half liters are needed.

note: you can and should drink a lot of liquid, unless there is a diagnosed kidney failure (acute or chronic form), a tendency to edema and problems from the cardiovascular system.

In the hot season, it is better to carry out "washing the body" in relatively cool morning and evening hours. In this case, most of the fluid will be excreted through the urinary system, and not through the sweat glands.

In addition, it is advisable to reduce the consumption of fatty, spicy, fried and salty foods. Spicy foods are also recommended to be avoided. Preference should be given to drinks with an alkaline reaction ( mineral waters), and the consumption of sodas, which include, for example, phosphoric acid (Coca-Cola, etc.) should be minimized.

Konev Alexander, therapist