Gianmarco ‘Gimbo’ Tamberi’s 2024 Paris Olympics are getting complicated. The high jump champion was struck by renal colic. He has now been discharged and has announced that he will participate in the high jump final scheduled for today. But what is a kidney stone? What does it depend on? And how is it treated? Experts at the Niguarda hospital in Milan explain, in an in-depth article published on the website of the Asst Grande Ospedale Metropolitano.
How widespread is it?
“Renal stones (or nephrolithiasis),” they describe, are created “when the concentration of lithogenic salts (calcium, uric acid, oxalate) in the urine increases, forming the first crystals which then, aggregating together, constitute the actual stone. This is a problem that affects 5 to 10% of the population.with a growing trend in recent decades, attributable to the greater consumption of animal proteins in our diet”. To avoid kidney stones, it is necessary to “keep the urine in a condition of undersaturation, that is, well diluted, ensuring constant and fractioned hydration to produce diuresis greater than 2 liters”. When they form, however, “stones are not all the same. There are different types: there are the most common ones formed by calcium salts, there are those of uric acid and those of struvite, resulting from a particular urinary infection. Then there can be those of cystine, caused by a rare hereditary pathology”, Niguarda specifies. “To diagnose the type of calculus, it is essential to analyze the composition of the stone once it has been expelled, through a chemical or crystallographic test”.
The symptoms
But how does a kidney stone manifest itself? “The most typical symptom”, precisely, “it’s renal colicthat is, a violent pain in the side accompanied by vomiting and restlessness, due to the movement of the stone along the urinary tract. Sometimes there may only be a dull lumbago, like back pain. Another possibility is the occurrence of macro or microhematuria even without symptoms, that is, the presence of blood in the urine. In the case of ongoing renal colic”, it is recommended to “not underestimate the phenomenon that could recur over time. It is also recommended to carry out blood and urine tests to identify the so-called metabolic risk factors. It is also important to carry out radiological checks, such as an ultrasound of the urinary tract and/or a CT scan of the abdomen without contrast”.
The cure
Therapy? Should kidney stones always be removed or can they go away on their own? “A stone around 6 millimeters has a high chance of spontaneous expulsion – the specialists at Niguarda answer – while the percentage decreases as the size increases. When they reach larger dimensions, therapeutic intervention is necessary. Until a few years ago, the only hope was surgery, which through different techniques resolved the situation by removing or fragmenting the stones. Now, however, lithotripsy has become widespread, which allows treatment without cuts. The lithotripter is a machine capable of producing shock waves that are sent precisely, with the help of X-rays or ultrasound, so as to be concentrated on the stones themselves. These waves pass through the soft tissues of the body and discharge their energy on the stones so as to fragment them. Ultrasound is able to highlight the number and size of the stones, location and possible presence of dilation of the excretory ducts”.
The power supply
Even diet can help. “The common therapy for all stones involves urinary dilution: drinking lots of liquids, lots of water, even tap water is fine – the experts clarify -. There are studies that confirm this: having a daily hydration equal to or greater than 2 liters limits relapses, which are frequent for this type of pathology”. Another piece of advice is “significantly reduce the consumption of salt and animal proteins, such as meat, fish and eggs”. “Contrary to what was thought until a few years ago – they finally point out from Niguarda – the diet must be normo-calcic. That is, you must not ban foods such as milk, cheese and yogurt”. Among other things, sometimes, “this could create major problems at a skeletal level, especially if the patient had high levels of calcium dispersion in the urine. In some cases, in fact, stones and osteoporosis can be correlated”.
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