Kidney Stones

　　Kidney stones are related to primary diseases, other diseases, and dietary habits. It is known that there are 32 components of urinary stones, the most common of which is calcium oxalate. Other components of stones such as ammonium magnesium phosphate, uric acid, calcium phosphate, and cysteine, etc., can also be mixtures of the above components.

　　1. Excessive accumulation of oxalic acid
　　The accumulation of a large amount of oxalic acid in the body is one of the factors leading to kidney stones. For example, vegetables, legumes, grapes, cocoa, tea, oranges, tomatoes, potatoes, plums, bamboo shoots, and other things that people commonly eat are foods that are high in oxalic acid.

　　2. Abnormal purine metabolism
　　Animal internal organs, seafood products, peanuts, green beans, spinach, and other foods all contain a lot of purine components. After purines enter the body, they undergo metabolism, and their final metabolite is uric acid. Uric acid can promote the precipitation of oxalates in urine. If a large amount of purine-rich foods is consumed at one time, and the metabolism of purines is abnormal, oxalates will precipitate in the urine and form kidney stones.

　　3. Excessive fat intake
　　Meat from various animals, especially fatty pork, is rich in fat. Eating too much of it will inevitably increase body fat, and fat will reduce the calcium that can be bound in the intestines, thus causing an increase in the absorption of oxalates. If there is a malfunction in the excretory function, such as excessive sweating, drinking less water, and less urine output, kidney stones may form in this situation. Therefore, doctors often say that in order to prevent kidney stones, it is necessary to drink more water in hot weather, and also drink more water when eating foods rich in oil and water, to promote smooth urination, dilute urine composition, and reduce the risk of kidney stones.

　　4. Increased sugar content
　　Sugar is an important nutrient for the human body, and it should be supplemented in moderation. However, if too much is added at once, especially lactose, it can also create conditions for the formation of stones.

　　5. Excessive protein intake
　　Chemical analysis of the composition of kidney stones found that 87.5% of the stones are calcium oxalate. The source of such a high proportion of calcium oxalate is that in addition to containing oxalate precursors such as glycine and hydroxyproline, proteins can also promote the absorption of calcium by the intestinal function. If high-protein foods are consumed excessively, it can cause the calcium, oxalate, and uric acid in the kidneys and urine to increase universally. If the excess calcium, oxalate, and uric acid cannot be excreted out of the body in a timely and effective manner through kidney function, the conditions for the formation of kidney stones and ureteral stones will be formed.

　　Patients with kidney stones may develop complications such as renal积水, renal insufficiency, urinary tract obstruction, and infection, which affect patients' lives and harm their health. Therefore, it is necessary to seek timely treatment as soon as symptoms appear.

　　Most patients with kidney stones do not have symptoms, unless the kidney stones fall from the kidney to the ureter, causing urinary obstruction. Common symptoms include back pain, night sweats, pain that makes one dizzy, nausea, vomiting, restlessness, abdominal discomfort, and hematuria. If complications such as urinary tract infection occur, symptoms such as chills and fever may also appear. Acute renal colic often causes patients to suffer severe pain.
　

　　Kidney stones are a common disease in life. When they occur, they may cause symptoms such as back pain, hematuria, and severe colic pain if the stones pass through the ureter. Patients suffer greatly, and they may recur frequently. Therefore, preventing kidney stones is also an important task in daily life. Below, I will introduce the methods of preventing kidney stones in daily life:

　　Avoid eating high-oxalate foods, such as strawberries, spinach, peanuts, and chocolate, all at once. It is also recommended to eat more high-fiber foods to help reduce the calcium content in urine.

　　Reduce the intake of caffeine-rich foods, such as animal viscera. In fact, all the foods we eat contain a certain amount of caffeine. During the digestion of caffeine, the body produces uric acid, and when the concentration of this uric acid reaches a certain level, it can offset other substances in the urine that help to eliminate stones.

　　Reduce the intake of animal proteins, such as pork and beef. These foods can make urine more acidic and increase the risk of calcium oxalate precipitation and crystallization. However, reducing does not mean completely not eating, as this is not conducive to maintaining our body's energy and muscle strength. When cooking these meats, you can add lentils, soybeans, or peas, and also pay attention to adding less salt to avoid the sodium in the salt increasing the calcium content in the urine.

　　Drink more water, and you can also drink some beverages without caffeine. In addition, pay attention to drinking less alcohol, maintaining the water content in the body, and staying away from the trouble of kidney stones.

　

　　Kidney stone patients must undergo urine tests, which are very valuable for judging the composition of kidney stones. The next is the basic serum biochemistry examination, which is the test of electrolytes, carbon dioxide binding power, creatinine, and uric acid. Then there are X-ray, ultrasound, CT scan. Finally, there is intravenous urography and magnetic resonance water imaging. The specific analysis is as follows:

　　1. Urinalysis
　　Protein is negative or trace, and red blood cells and white blood cells can be seen under microscopy. Urine culture may show bacterial growth, and various crystals and crystal aggregates may be seen in the urine. Characteristic urine crystals are meaningful for the diagnosis of stone type. Calcium oxalate stones show pseudotubular calcium oxalate crystals in the urine; uric acid stones show complex crystals; cystine stones show hexagonal crystals. The urine pH varies with the composition of the stones, infectious stones and calcium phosphate stones have urine pH>6 and bacteria, urine bacteriology culture and drug sensitivity test should be performed; uric acid and calcium oxalate stones have lower urine pH.

　　2. Serum biochemistry basic examination
　　Electrolytes (calcium, phosphorus, potassium, sodium, chlorine), carbon dioxide binding power, creatinine, uric acid. If blood calcium is high or at the upper limit of normal, especially if blood phosphorus is low, thyroid function should be checked. If there is hypokalemia and a decrease in blood bicarbonate concentration, there may be a low citrateuria.

　　3. Urinary tract X-ray film
　　There are no specific contraindications for kidney stone patients, and this examination is required. X-ray films must include the entire urinary system. Urinary tract X-ray films can detect about 90% of X-ray-opaque stones, and can roughly determine the location, shape, size, and number of stones. It provides basic information for whether further examination is needed and can be used as a routine method for stone examination. Calcium oxalate is the best for contrast; calcium phosphate, magnesium ammonium phosphate, and calcium-containing cystine and uric acid stones are slightly worse for contrast; uric acid and xanthine stones are X-ray penetrable; cystine stones have low density and are faintly visible on X-ray films.

　　4. Intravenous urography
　　This examination can understand the anatomical and functional status of the kidney, such as pelvis belonging to the intrarenal type or renal shape, pelvis-ureteral junction stenosis, polycystic kidney, and the presence of renal积水. Negative stones appear as clear areas in the contrasted pelvis, similar to space-occupying lesions. In cases of poor renal function and poor contrast, the use of large doses of contrast agents can be considered. In some cases, retrograde urography can also be considered.

　　5. Ultrasound
　　Ultrasound examination is simple, economical, and non-invasive, and can detect stones that are 2mm or more opaque or X-ray penetrable. Due to the influence of intestinal air, the sensitivity to lower ureteral stones is low, and it can be used in conjunction with urinary tract X-ray films. Ultrasound examination can also detect the dilatation of the upper urinary tract above the stones.

　　The main cause of kidney stone formation is diet, which is caused by excessive intake of components that can form stones in the diet. Patients with kidney stones need to be more vigilant about their diet to prevent the恶化 of their condition.

　　1. Drink more plain water:Drinking plenty of water can dilute urine, reduce the concentration of calcium ions and oxalate ions, and prevent the formation of calcium oxalate kidney stones. Studies have shown that increasing urine volume by 50% can reduce the incidence of kidney stones by 86%.

　　2. Reasonable calcium supplementation:Patients with kidney stones often 'fear calcium' and mistakenly believe that calcium is the culprit of kidney stones. In fact, this is not the case. Patients with kidney stones also need to supplement calcium.

　　3. Be cautious about drinking milk before going to bed:Drinking a glass of milk before going to bed can help sleep. However, after sleep, urine volume decreases, and various solid substances in urine increase. The 2-3 hours after drinking milk are the peak time for calcium excretion through the kidneys. A sudden increase in calcium excretion through the kidneys in a short period of time is easy to form stones. Therefore, patients with kidney stones should not drink high-calcium milk before going to bed.

　　4. Limit the intake of sugars:The intake of high-sugar foods can increase the chance of kidney stones. Therefore, attention should be paid to eat less sweet foods.

　　5. Do not take too much cod liver oil:Cod liver oil is rich in vitamin D and has the function of promoting the absorption of calcium and phosphorus by the intestinal membrane, which will increase the excretion of calcium and phosphorus in urine, causing precipitation and easy formation of stones. Therefore, excessive intake of cod liver oil is not recommended.

　　6. Eat less bean products:Soybean products contain a high amount of oxalates and phosphates, which can combine with calcium in the kidneys to form stones.

　　7. Eat less food high in oxalates:Foods high in oxalates include tomatoes, spinach, strawberries, beets, chocolate, etc., and excessive intake of oxalates is also one of the main causes of kidney stones.

　　Mild kidney stones can be treated with traditional Chinese medicine. Only by fully understanding the requirements for the use of stone-dispelling medicine can patients make the best self-choice among various treatment methods.

　　Formula One
　　Traditional Chinese medicine for kidney stone syndrome: kidney yin deficiency, with damp-heat.
　　Treatment method: Invigorate the body and nourish yin, clear heat and drain dampness.
　　Formula name: 四六利湿汤.
　　Composition: 12 grams of dangshen, 9 grams of poria, 9 grams of raw earth, 9 grams of rhizoma alismatis, 9 grams of cow knee, 9 grams of artemisia, 9 grams of atractylodes, 9 grams of anemarrhena, 12 grams of sericea, 12 grams of white root, 3 grams of licorice.
　　Take it in decoction, 1 dose per day, twice a day.

　　Formula Two
　　Dialectic: Phlegm blocking blood stasis.
　　Treatment method: Drain dampness and resolve phlegm, activate blood circulation and remove blood stasis, clear heat and detoxify, relieve urgency and relieve pain.
　　Formula name:八角金盘汤.
　　Composition: 5 grams of八角金盘 (ground and swallowed), 5 grams of amber, 15 grams of motherwort, 10 grams of winter melon seeds, 10 grams of talc, 30 grams of rehmannia root, 30 grams of red bean, 5 grams of tangerine peel, 5 grams of licorice.
　　Take it in decoction, 1 dose per day, twice a day.