Complications communes des calculs rénaux

Complications of kidney stones

Urinary obstruction

The obstruction of the urinary tract can cause the accumulation of water in the obstruction area.

The calculi obstruction often is incomplete obstruction, some of the stone surface have small groove, urine can follow small communication;

Stone is larger, sometimes even cast shaped stones, but the urine can still flowed around the stones, may also be in a long time not cause water, renal pelvis wall thickening, fibrous tissue hyperplasia, expansion performance is not obvious.

The clinical manifestation of renal calculi is very different due to its different onset.

Although the result can cause the hydronephrosis, it is not necessary to have the main performance of the renal pelvis.

There are sometimes no clinical symptoms in the hydronephrosis, and some cases are not found until the renal pelvis has reached a serious degree, abdominal mass and renal insufficiency, even when there is no urine.

Local damage

Big stones, small and mobility of local tissue injury is very light, big and fixed staghorn calculi can make the calyces, falls off the epithelial cells of the renal pelvis, ulceration, fibrous tissue hyperplasia, neutrophils and lymphocytes infiltration and fibrosis.

After long-term calculi stimulation, squamous cell metaplasia can occur, and even squamous cell carcinoma can be caused. Therefore, it should be examined in the urine shedding cytology.

Although the abnormality of the diuretic cells may not confirm the diagnosis, it can obtain the indication of abnormal changes in the urothelial cells.

For long-term renal pelvis or bladder stones, it is possible to consider the possibility of epithelial cell carcinogenesis. The biopsy should be carried out by living tissue during operation.

The infection

There is an important significance in the treatment and prevention of renal calculi.

The clinical manifestations of urinary tract infection were fever, lumbago, and pus cells in urine.

When the urine is cultured with bacteria, it should be used for drug susceptibility test.

When a stone is combined with infection, it can accelerate the growth of stones and the damage of renal parenchyma.

It is difficult to cure the infection before the stone is expelled or taken out. It can occur with pyelonephritis, pyrrosis, renal peripheral inflammation, severe and even development of renal abscess.

After adhesion to the peritoneum, it can be worn into the intestinal canal.

Under the microscope, there are renal interstitial inflammation, infiltration and fibrosis of the cells, neutrophils and epithelial cells in the renal tubules, and renal tubular atrophy and glomerular sclerosis in the later stage.

Renal insufficiency

Renal calculi can occur in patients with renal insufficiency when combined with urinary obstruction, especially bilateral urinary obstruction or combined with severe infection on this basis.

When obstruction is removed and/or infection is effectively controlled, some patients.

Kidney function can improve or return to normal.

In addition to detecting the removal of serum urea nitrogen, creatinine and endogenous creatinine, the method of determining renal function can be determined by intravenous pyelography and the time and concentration of the contrast agent.

Although b-ultrasound can understand the expansion of urinary tract and the thickness of renal parenchyma, it is difficult to judge the renal function.

Static or dynamic nuclide scanning or video can provide valuable clues.

Because of the obstruction and renal damage along with the change of stones mobile parts, and different stages of treatment and changes, so kidney stone patient requires follow-up monitoring, especially the dynamic scanning to get hold of renal parenchyma.

When the stones are removed, or after drainage, such examinations provide a basis for prognosis or further treatment.

Renal calcareous deposition

Calcium is composed in the renal tissue and is born in patients with high blood calcium.

Primary hyperparathyroidism, renal tubular acidosis and chronic pyelonephritis can have renal calcareous precipitation.

Calcium mainly precipitates in the medulla.

When the lesion is serious, all the renal parenchyma can be calcareous, leading to interstitial fibrosis, glomerular sclerosis and small tubular atrophy.

Renal tissue is replaced by adipose tissue

The renal tissue atrophy of renal pyelonephritis can be replaced by adipose tissue.

The kidneys maintain their original shape but generally shrink.

The renal capsule is closely adhered to the surface of the kidney, and the renal tissue is atrophied and hardened.

The renal tissue in severe cases is minimal, or even completely eliminated.

The renal parenchyma and the renal pelvis were filled with a gray-yellow fat tissue.

Gastrointestinal symptoms, anemia, etc.