GERD is linked to kidney stones
Kidney stones: causes, symptoms, treatment
SOS - first aid tips for kidney stones
If a urinary tract infection and an additional fever occur due to kidney stones, this is an emergency. The person concerned then has to go to hospital immediately. Because fever and chills can sometimes point to life-threatening blood poisoning. The doctor then immediately drains the urine and treats the patient with antibiotics.
What are kidney stones?
Kidney stones are deposits that form from the crystallized components of the urine. The stones can arise in the tubules of the kidney, in the renal pelvis or in the urinary tract. There are kidney stones that are as small as a grain of rice, but also those that fill the entire kidney pelvis (so-called pouring stones).
A kidney stone often travels through the urinary tract and is then named for its location. Doctors also speak of ureter stones, a urinary bladder stone or a urethral stone if the crystal is deposited in one of these places. Pain usually only occurs when kidney stones migrate into the ureter. Then renal colic can occur.
Around every fifth German is diagnosed with kidney stones at least once in their life. This usually takes place between the ages of 30 and 60 years. Men are affected much more often than women.
Kidney Stones - Symptoms
Those affected often feel nothing at all from their kidney stones. Then the stones are small and rest in the kidney. In this case, they are usually discovered by chance during an ultrasound or X-ray examination of the abdomen. They may also cause only mild symptoms, such as pulling in the kidney area. Urinary tract infections or traces of blood in the urine can also result. If small stones are discovered in the kidney, you should drink plenty of fluids. Often the body can flush out a small stone with the urine on its own.
The larger the size of the kidney stones, the more severe symptoms they can trigger. If a large stone from the kidney gets into the ureter, it can block or even close it, especially in narrow areas. This leads to urinary congestion and the muscles of the ureter tense around the kidney stone. One then speaks of renal colic. Renal colic usually occurs in waves in the area of the kidneys and lower back.
Renal colic can lead to these symptoms:
- Severe labor-like pain that starts suddenly.
- The cramp-like pains usually run in waves. They initially swell and then subside again.
- The symptoms show up in the kidneys and lower back. They can radiate into the abdomen and genital region.
- The pain is usually associated with nausea and vomiting.
- Frequent urination with only small amounts of urine may occur. Often the urge to urinate cannot be suppressed.
- You may also experience pain when urinating or blood in your urine.
- Depending on the location and size of the stone, the symptoms can be very intense and last a long time.
Quick action is necessary if a urinary tract infection and a fever occur in the case of a stone disease. This emergency must be treated quickly in a urological clinic. In rare cases, fever and chills also indicate blood poisoning. Then the doctor will treat the urinary obstruction immediately by draining the urine and administering antibiotics.
Kidney stones - causes
There are different causes for the formation of kidney stones. Initially, the crystals are small. Over a long period of time they continue to grow and merge. Kidney gravel is formed first, from which kidney stones later develop. The stones can be composed of different minerals. The most common types of stone include:
Calcium oxalate stones
When there is too much oxalic acid and calcium in the body, calcium oxalate builds up especially in the urine. This increases the risk of developing a urinary stone. Around three quarters of all diagnosed urinary stones consist of this salt. The cause of the excessive occurrence in some people is mostly due to a diet rich in oxalates, but various diseases can also be a reason. An overactive parathyroid gland, for example, can be responsible for increased calcium levels. If there is an increased oxalic acid level, a disease with bile acid loss, such as Crohn's disease or short bowel syndrome, may be behind it.
About ten percent of kidney stones consist of the mineral struvite. They sometimes arise as a result of a urinary tract infection. Doctors also refer to the stones as magnesium ammonium phosphate stones or triple phosphate stones due to their composition.
Uric acid stones
The consumption of purine-rich foods, such as meat, offal, fish or seafood, can increase the uric acid levels in the body and thus promote the formation of uric acid stones. The risk of developing uric acid stones increases if someone has gout.
Kidney stones are caused by the urine becoming too saturated with stone-forming substances. The causes of this oversaturation include, for example:
- Increased excretion of stone-forming substances such as calcium, oxalate, phosphate or uric acid. As well as a reduced excretion of non-stone-forming substances such as magnesium and citrate.
- An increased concentration of urine. The reasons for this can be lack of fluids or dehydration, as well as a tropical climate or chronic intestinal diseases.
- A disorder in calcium metabolism. For example, through an overactive parathyroid gland with increased excretion of calcium.
- A disorder in uric acid metabolism with increased uric acid excretion. Reasons for this can be an enzyme defect or a diet high in purine with a lot of meat or alcohol abuse. The disintegration of tumor tissue can also lead to this.
- Urine with a pH of less than 5.5 (for uric acid stones) or greater than 7.0 (for phosphate stones)
The formation of kidney stones can be promoted by other factors. These include:
- Taking supplements with calcium and vitamin D.
- An obstruction of the urine due to scars, narrowing or malformations in the kidneys or urinary tract.
- Taking certain medications such as acetalzolamide, sulphonamides, triamterene, indinavir. In addition, when taking acetylsalicylic acid in very high doses (more than 4 grams per day).
- Repeated urinary tract infections.
- When kidney stones are more common in the family.
- Insufficient fluid intake.
Kidney stones - diagnosis
The doctor will have the type of symptoms described exactly. During the physical examination, the abdomen and back, among other things, are carefully palpated and tapped. If the suspicion of urinary stone is confirmed, further investigations will follow. The blood analysis can, for example, provide information about whether the electrolyte and uric acid levels are abnormal. You may also find blood when you check your urine. The kidney stone can be easily identified during an ultrasound examination if it is in the kidney or ureter near the bladder. You can recognize kidney stones from a size of around two millimeters. In addition, one can assess the kidney function and determine any urinary stasis. Computed tomography is also often used. This shows whether there are stones and how big they are. An additional X-ray examination is usually carried out with the administration of contrast medium. If necessary, information can be obtained about the drainage conditions from both kidneys.
Kidney stones - treatment
Small stones that are discovered by chance during an examination do not necessarily need to be treated. This only applies, however, if the kidney stones do not cause pain, do not cause a urinary infection or urinary flow disturbance. If patients are in pain, pain relievers such as paracetamol or diclofenac can be helpful. Regular checks are often sufficient for small stones. In consultation with the treating urologist, you can sometimes just wait and see whether a stone will go away with the urine by itself. This is often the case when it is smaller than seven millimeters. It is often recommended to catch the stone while urinating. This can usually be done with a sieve or a coffee filter bag. This is useful for examining the composition of the small crystals. With this knowledge, you can specifically prevent the formation of further kidney stones. - A stone loss can often be supported by targeted measures:
- Drink a lot (water or tea). However, this should definitely be done in consultation with the doctor.
- Move in a targeted manner. Hopping, for example, can be a good way to move stones in the ureter.
- Certain medications can sometimes make stone removal easier. The urologist recommends suitable active ingredients.
If a spontaneous loss of the kidney stone can be ruled out, the crystal is usually actively removed. This also applies if the pain cannot be controlled with medication or if there is a risk of kidney damage. Which therapy is used also depends on the composition of the stone as well as its location and size. It also plays an important role whether the stone is still in the renal pelvis or already in the ureter. The following treatments are commonly performed:
In some cases, kidney gravel and kidney stones can be dissolved with the help of special substances. These can be taken orally or delivered through a catheter.
Extracorporeal shock wave lithotripsy (ESWL)
Before starting treatment, the location of the kidney stones is precisely determined. This is done either by ultrasound or X-rays. Subsequently, mechanical pressure waves or shock waves are aimed at the stone from the outside. They penetrate the tissue and shatter the stone. The resulting individual fragments can subsequently escape spontaneously and be excreted in the urine.
Percutaneous nephrolitholapaxy (PCNL)
The doctor drills a thin canal to the kidney with a puncture needle. He then guides an optical instrument through the canal, smashes and removes the kidney stones.
If kidney stones have migrated into the ureter, this kidney stone operation is used. The doctor pushes a straight or flexible endoscope over the urethra and bladder into the ureter, sometimes up to the kidney. This gives him a picture of the inside of the ureter and the renal system. Since the instrument has additional connections for irrigation fluid and working channels, stones can also be crushed in the ureter or kidney using a laser probe. Fine tongs and baskets transport the crushed stones away.
Homeopathy for kidney stones
A kidney disease affects the entire organism because it is the most important excretory organ. Around 180 liters of fluid pass through healthy kidneys every day. If there are acute complaints, medical advice should always be sought. For the preventive treatment of kidney stones and also to alleviate the symptoms of renal colic, homeopathic medication can be used as a support. These homeopathic remedies are often recommended for kidney stones:
- Solidago: If you have a tendency to kidney gravel or kidney stones. Supports the stone finish. Also for the prophylaxis of uric acid stones.
- Sarsaparilla: For colic, cramp-like pain, for kidney stone formation and loss.
- Lithium carbonicum: For kidney stones with frequent urination and burning. If the urine looks cloudy and has a lot of mucus in it.
Acupuncture for kidney stones
The traditional Chinese understanding of acupuncture is based on the idea that the entire organism is criss-crossed by a dense network of so-called meridians. The life energy flows through them. Symptoms of the bladder and kidneys can be treated with acupuncture. The method is often used to relieve pain caused by kidney stones. However, the therapy should only be carried out in consultation with the treating urologist.
Kidney stones - prevention
The formation of new kidney stones can be actively counteracted. The following tips should be heeded:
- Ensure adequate hydration: Adults should drink between 1.3 to 1.5 liters of water or other unsweetened drinks throughout the day. - The German Nutrition Society recommends this amount for adults to drink, unless there is nothing to prevent it from a medical perspective.
- Eat a balanced diet: A diet with lots of vegetables, salad, fruit and whole grain products is recommended. The consumption of animal protein should be reduced.
- Eat little salt: It is best to cook fresh and do not consume ready-made meals. These often contain too much salt. In addition, you can counteract high blood pressure with a low-salt diet.
- Avoid or reduce obesity: Because the risk of developing urinary stones decreases with normal weight.
- Exercise regularly: Exercise can help prevent small kidney stones from becoming stuck in the first place.
Diet tips for preventing kidney stones:
- Seldom include meat and sausages on the menu.
- Avoid foods rich in purines. These include some types of fish such as herrings, mackerel or anchovies as well as inner eggs.
- Significantly reduce the consumption of salt and sugar (sweets).
- Prefer whole grain products.
- Eat lots of vegetables and fruits. Be careful to avoid products with a high oxalate content. Therefore, for example, spinach, beetroot or rhubarb should be avoided.
- Eat nuts only in small quantities.
Drugs for the prevention of kidney stones:
The urine can be made more basic or acidified with the help of medication. Depending on how the previous kidney stones were composed, the doctor may prescribe thiazides, allopurinol, or minerals. The active ingredients ensure that the metabolic products excreted by the kidney do not precipitate as crystals and do not combine.
Kidney Stones - ICD Code
In medicine, every illness is assigned its own ICD code. The abbreviation ICD stands for International Statistical Classification of Diseases and Related Health Problems. The classification system is recognized worldwide and is one of the most important for medical diagnoses. A kidney stone is recorded under the ICD code: "N20". Entering this code often helps with research on the Internet.
Kidney stones - what does the health insurance company pay for and what do you have to pay for yourself?
Members of a statutory health insurance basically have the right to inpatient and outpatient care, to drugs and other services. As a rule, however, certain personal contributions (additional payments) are stipulated by law. These additional payments amount to 10 percent of the costs, but a maximum of 10 euros per additional payment. If the service costs less than 5 euros, the insured person must pay the actual price.
These limits also apply to pharmaceuticals. If the person concerned receives a particularly inexpensive preparation, there is no additional payment. The health insurances can determine fixed amounts that they reimburse, provided that several preparations with the same active ingredient are available. Medicines, the price of which is 30 percent below this fixed amount, are reimbursed by the health insurance companies without additional payment.
In addition, there is a regulation that the statutory health insurance no longer has to reimburse the individual price of the respective drug for certain preparations, but only the fixed amount that has been set for a group of comparable preparations. If the prescribed medication is more expensive, the patient has to pay the additional price himself plus the statutory additional payment for the reimbursed portion of the costs.
Co-payments also apply in the event of a hospital stay. They amount to 10 euros per calendar day, whereby the additional payment only has to be made for a maximum of 28 days per year. Several hospital stays can be combined in one year, so that the maximum additional payment for inpatient treatment is 280 euros per calendar year.
In the case of home nursing, a one-time fee of ten euros is due for the prescription. In addition, a personal contribution of 10 percent per day is to be paid. The co-payment is limited to 28 calendar days per calendar year and is only charged for adults over 18 years of age. The upper limit of EUR 280 per calendar year also applies to home care. Co-payments for hospital stays count towards the cap on co-payment for home nursing.
If the costs for household help are covered by the health insurance, the insured must make an additional payment of 10 percent of the costs incurred. The limits are at least 5 and a maximum of 10 euros per calendar day. This co-payment obligation applies to the entire period in which domestic help is used.
In the case of aids, the insured must make an additional payment of 10 percent of the selling price, with an upper and lower limit of 10 and 5 euros per prescription.
The amount of co-payments for rehabilitation measures depends on the measure and the respective cost bearer.
The costs for pain therapy in a pain clinic are usually covered by any statutory health insurance company, as it is a contracted medical service. However, additional costs (such as additional payments for prescriptions) may arise privately.
The costs of a classic body acupuncture are covered by all statutory health insurances for chronic pain in the lumbar spine or knee osteoarthritis. It is assumed that the pain has existed for at least six months. In such cases, legally insured persons are entitled to up to ten acupuncture sessions per case of illness within a maximum of six weeks. A new treatment can take place no earlier than twelve months after completion of the last acupuncture treatment. The health insurance will only reimburse the costs if the treatment is carried out by a qualified doctor. Acupuncture from a naturopath is not accepted. The costs are then to be paid privately.
Kidney stones - what does the DFV take care of?
The outpatient supplementary health insurance DFV-AmbulantSchutz reimburses you for additional payments provided for by law for medicines, bandages, remedies and aids and travel costs as part of outpatient treatment. The DFV-AmbulantSchutz also offers you extended pension benefits and is also there to support you financially if a serious illness is diagnosed.
In the event of illness, with the additional hospital insurance DFV-KlinikSchutz Exklusiv, you do not wait longer than 5 days for an appointment with a specialist doctor.
You also benefit from head physician treatment, a single room, free choice of hospital and daily hospital allowance for an inpatient clinic stay. DFV-KlinikSchutz makes you a private patient in the hospital including international health insurance.
FAQ about kidney stones
Can you get kidney stones more often?
Kidney stones can recur. About half of the patients who have been treated for kidney stones will develop stones again within a period of ten years. With consistent prophylaxis, however, the risk of relapse can be significantly reduced.
Are Kidney Stones Dangerous?
Kidney stones can cause complications. These include inflammation of the renal pelvis, blood poisoning due to inflammation of the lower urinary tract, and constrictions in the urinary tract. In the extreme case, kidney stones can lead to acute kidney failure.
What drugs can dissolve kidney stones?
If the stones are made of uric acid, medication can sometimes help dissolve them. For example, the active ingredient allopurinol changes the uric acid concentration in the blood. The uric acid level can also be influenced by changing eating habits. Medicines that make the urine more alkaline can also help clear a stone.
Which foods should you avoid if you have kidney stones?
In about 50 percent of all cases, urinary stone recurs. A poor diet often contributes to this. However, a targeted change in diet can often prevent a new formation. You should therefore avoid red meat and sausage, among other things. Foods rich in purine such as offal and certain types of fish such as herring or mackerel are also unfavorable. Those affected should also limit the consumption of salt and sugar. Caution is also advised when consuming too much calcium, for example from dairy products and some mineral waters. People who are overweight are also at increased risk. It is also recommended to drink as little alcohol as possible.
What are the symptoms of renal colic?
Typical symptoms of renal colic include sudden, cramp-like pain that occurs in waves. Depending on the location of the kidney stone, the severe pain radiates into the back, the lateral lower abdomen, the groin or the genital region. In addition, there is nausea and vomiting. Often there is also blood in the urine. Those affected have to urinate frequently, with only small amounts of urine and the urge to urinate that cannot be suppressed. Often there is also a reflex bowel obstruction, an additional urinary tract infection, sweats and fever.
- Herold, Gerd: Internal Medicine, Gerd Herold, edition 2019
- German Society for Urology, www.urologenportal.de (accessed April 20, 2021)
- S2k guideline for diagnosis, therapy and metaphylaxis of urolithiasis (as of 2019), www.awmf.org (accessed April 20, 21)
- NDR "Kidney Stones: Prevention, Symptoms and Correct Treatment" (accessed April 22, 21)
- Bulbak, Robert "Kidney stones. Pain-free after renal colic?", From November 22, 2017, www.aerztezeitung.de (accessed on March 31, 2021)
- Leitzmann, Claus; Müller, Claudia, et al: Nutrition in Prevention and Therapy, 3rd edition 2009
- Die Techniker, www.tk.de (accessed April 21, 2021)
- HalloVita Verlag: www.hallo-homoeopathie.de (accessed April 23, 2021)
- German Academy for Acupuncture: www.akupunkt.de (accessed April 23, 2021)
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