Urolithiasis disease Done by :Alimkulov A. 233GM Checked by: Omarov T.M

The pathogenesis of stone formation is complex and is determined by both general and local factors. Common factors that are of primary importance for the formation of stones include metabolic disorders of acquired or hereditary nature. Of particular importance are violations of the metabolism of fats (cholesterol), nucleoproteins, a number of carbohydrates, minerals.

The clinical significance The clinical significance and consequences of stone formation can be very serious. As a result of the pressure of the stones on the tissue, it may become necrotic (renal pelvis, ureter, gallbladder and bile ducts, vermiform appendage), which leads to the formation of pressure sores, perforation, adhesions, fistulous strokes. Stones are often the cause of inflammation of the cavity organs (pyelocystitis, cholecystitis) and ducts (cholangitis, cholangiolitis). Violating the secretion, they lead to severe complications of general (for example, jaundice with blockage of the bile duct) or local (for example, hydronephrosis with blockage of the ureter).

Urolithiasis disease

Types of stones Calcium stones X-ray positive Most common in men The first stone is formed and is revealed at the age of years. The second is formed over the next 10 years. After removing the stone, the formation is new for 2-3 years. Uranium stones X-ray negative Half of the patients suffer from gout Half have a complicated hereditary history

Urolithiasis disease Calcium stones Grow on the kidney papillae. With ultrasound or radiographic examinations, multiple calcification, nephrocalcinosis, can be seen. As a rule occur with severe hypercalciuria. Putty Cystine and uric acid in high concentrations precipitate in the form of "putty". May cause ureteral obstruction During the day can drop 1 g of uric acid and mg of cysteine. Oxalates "putty" do not form

Urolithiasis disease Stones are seen as a constant source of infection It is localized on the stone itself Violation of the passage of urine

Urolithiasis disease For diagnosis, the ICD Kidney ultrasound Radiography of the kidneys - excretory and overview urography Definition Calcium Uric acid PH of urine Oxalates and citrates in urine Electrolytes

Urolithiasis disease General principles of treatment Always combined - therapist + surgeon Avoid dehydration Drinking volume is selected individually by volume of urine ( 2 l / day) Assess the localization of the stone, the volume, the function of the kidney, the presence of infection, the formation of indications for the operation Removal by open access, endoscopically, with cystoscopy, by remote lithotripsy.

Urolithiasis disease When verifying calcium stones The drug of choice is thiazide diuretics When verifying urate stones PH increase in urine Decreased excretion of uric acid - the goal is less than 1 g / day Diet with a reduced content of purines Alkaline solutions (drink) Allopurinol 100 mg / day

Urolithiasis disease Cysteine stones Abundant drink - more than 3 liters PH more than alkalinization of urine Penicillamine - forms a complex with cysteine Triplesulfate stones Treatment: Surgical Surgical introduction of citrate mixtures for the dissolution of stones.

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