Contents
Urate stones are formations that are most easily amenable to dissolution with the help of drug therapy. Uric acid salts, of which they are composed, are effectively dissolved with the help of litholytic therapy drugs.
How to identify urate stones?
X-ray examination is not able to diagnose urate stones due to their low density, but they are clearly distinguishable on ultrasound. You can determine the composition of the formation by examining it after surgical removal or independent exit from the urinary tract. It is possible to determine the composition of the stone in the body using diagnostic methods. If the pH of the urine deviates from the norm towards acidity, it is most likely a urate stone. The exact density of the formation is determined using computed tomography.
But CT is not necessary if there are the following signs:
On ultrasound, the stone is visible;
On the X-ray, the urate stone is not determined;
Urine studies have found a pH shift towards an acidic reaction.
If these signs coincide, it is worth trying to dissolve the stone. Most often, such formations occur in patients with impaired purine metabolism. For this reason, if you suspect the presence of urolithiasis, you should conduct a study of the level of uric acid in the blood.
The role of urine pH in the dissolution of urate stones
To dissolve urates, an alkaline drink is prescribed, which increases the level of acid-base balance. Citrate preparations are designed to convert urine from acidic to slightly acidic or alkaline. The dissolution of urate stones with the help of drug therapy takes from 2 months to six months.
To speed up this process, the following tactic is used – preliminary remote or contact endoscopic crushing of both mines larger than 2 cm, and subsequent dissolution of the remaining small fragments. Treatment is accompanied by abundant drinking and adherence to a special diet.
Most often, patients seek medical help when the stone has moved from the place of its formation and moves from the kidney along the urinary tract. Movement is accompanied by acute pain due to renal colic, and the appearance of obstructive pyelonephritis. Since there is no time for a long process of dissolving a large stone, the stone is removed by any available method, and the remaining formations are then dissolved.
Dissolving urate stones with plain water
With an increased amount of fluid consumed, the pH of the urine shifts towards a decrease in acidity. As a result, the concentration of salts decreases, and small urate formations dissolve. If the stone has a mixed composition, or it is not possible to maintain a constant elevated pH level of the urine by taking citrate preparations, then their further use does not make sense. If the treatment gives a result, then citrate mixtures should be used further, but under the guidance of a urologist or nephrologist, since preparations for dissolving stones have pronounced side effects.
We note the important fact that alkalization of urine reliably dissolves only uric acid formations. Although it is possible to dissolve oxalate formations using citrate mixtures, in practice this is not so effective. As a rule, citrate preparations are taken for prevention, after crushing calcium-oxalate kidney stones.
Will lemon or cranberry juice dissolve urate stones?
No, these drugs are unable to dissolve stones, citric acid only minimizes the absorption of calcium in the gastrointestinal tract. Abuse of such recommendations can lead to gastric bleeding and other negative consequences up to stomach ulcers.
Is it safe to drink diuretic herbs?
Uncontrolled intake of kidney teas leads to dangerous consequences. The stone in the kidney, under their action, can move at the most inopportune moment. As a result, an acute inflammatory process develops, the patient experiences acute pain in renal colic.
There is no sand in the kidneys
The diagnosis of “urolithiasis” to the patient is made under the following conditions:
The size of the stone is more than 0,5 cm;
It has a dense structure;
Ultrasound does not pass through the stone (there is an acoustic track).
In medical practice, they do not diagnose “sand in the kidneys.” What is mistaken for “grains of sand” on ultrasound is encrusted papillae of the kidneys, vessels or compacted fiber. Do not drink diuretics at the first suspicion of “sand in the kidneys.” An ultrasound scan should be done every 6 months, determining the dynamics of changes in the renal structure and foreign formations located in it. If no growth of stones is noted, most likely, these are individual features of the structure of the kidney.
Diet for urate kidney stones
Dietary nutrition is an important component of the treatment of urolithiasis. It is prescribed taking into account the general condition of the patient, the presence of somatic diseases. So, for example, in cardiovascular disorders, it is required to limit the amount of fluid entering the body. Patients suffering from diabetes should adjust the recommended diet according to their needs.
It is necessary to maintain a balance of substances that the body needs for normal functioning, and not to use a diet for a long time. Otherwise, stones of a different composition will begin to form.
The basic principles of the diet in the presence of urate stones:
Restriction of products that provoke urolithiasis;
The use of products that affect the change in the reaction of urine;
Increasing the amount of liquid used to remove the sediment of salts.
For therapeutic effects, products with a minimum of purines are recommended: bread, dishes from vegetables, fruits (with the exception of crops prohibited for consumption), dairy products, nuts, berries, cereals. Dishes from lean combs of meat and fish are allowed in boiled form, 1 egg per day, the use of butter or ghee.
Prohibited products:
Meat by-products;
Legumes, peanuts;
Vegetables: cauliflower, sorrel, spinach;
Fruits: raspberries, figs, cranberries;
Mushrooms;
Horseradish and mustard as seasoning;
Butter baking;
Coffee, cocoa, hot chocolate;
Refractory fats: beef, lamb, culinary;
Canned food;
Salty and spicy cheeses;
Sausages.
With the recovery of the patient, the diet is gradually adjusted, returning to the usual level.