Steps

Kidney stones

1. Also called renal or urinary lithiasis, causing renal colic
2. A stone is a concretion (stone) formed by mineral salts, not processed by the body
3. This can be due to insufficient hydration or diet (excess salt and animal protein, or a lack of fruits, vegetables, and dairy products)
4. (i) Generally, a stone can be eliminated naturally up to 3/4 mm
5. /!\ You can therefore have one without even knowing it, but if it is larger and/or obstructing a ureter, then you will be in crisis

Renal colic (the crisis)

1. This is a sharp, unilateral, lumbar pain
2. It is most often due to the presence of a stone in one of the two ureters
3. (i) No matter what position you lie in, the pain will not go away, you must go to the emergency room for a CT scan
4. /!\ Women who have given birth and have also experienced renal colic in their lives, explain that the pain is comparable
5. Required emergency room visit
6. Emergency room (health card and ID card)
7. Pain medication (usually morphine)
8. CT scan
9. Continued if not blocking
10. Medications and return home
11. Follow-up ultrasound within a week, to allow time for the medication to take effect
12. Until the medication takes effect and the inflammation subsides, it is best to limit the number of water (or syrup) intakes per hour and the number of sips (e.g., 2 per 60 minutes) to avoid another attack if it becomes blocking
13. /!\ You will feel the pain coming on gradually and not all at once, to give you time to get back to the emergency room
14. Increase the number of intakes per hour and the number of sips gradually (e.g., 2 per 60 minutes, then 3 per 60 minutes, 3 per 45 minutes, 3 per 30 minutes, 4 per 30 minutes, etc.)
15. Check to see if you have passed any fluid (and have it analyzed)
16. Wait for the follow-up ultrasound to be sure in all cases
17. Follow-up if blocking (or becomes blocking)
18. Stay in the emergency room to monitor progress, with urine collection (in case it passes naturally)
19. If it still doesn't pass, try to burst the stone with ultrasound to avoid damage around it (general anesthesia)
20. If the ultrasound isn't enough, then insert a JJ catheter naturally (immediately after the ultrasound)
21. (i) The JJ catheter is approximately 30 cm long and connects the kidney to the bladder, to create an unobstructed channel for urine
22. Monitor in the hospital, with pain medication
23. Return home, with pain medication
24. Wait more than a month to allow time for the stone to pass
25. Scan to see if there are more stones
26. If it still doesn't pass, the stone will go away when the JJ catheter is removed (general anesthesia)
27. If the JJ catheter was inserted, there's a good chance it will irritate any the ureter, and a second temporary JJ catheter is inserted
28. If a second temporary JJ catheter is inserted, it will be removed by the surgeon in his office, assisted by nurses and nursing assistants, under local anesthesia (cream, then injection)
29. Return home
30. Medications are generally:
31. Ketoprofen Biocaran L.P. 100mg (anti-inflammatory, for 7 days, morning and evening)
32. /!\ Do not exceed 10 days, due to the risk of addiction
33. Lansoprazole Biocaran 30mg (gastric protaster, for 7 days, evening)
34. Tamsulosin Biocaran L.P. 0.4mg (muscle relaxant, for 7 days, morning)
35. Doliprane Effervescent 1000mg (optional, paracetamol)
36. (i) Dafalgan Codeine (level 2 painkiller, prescription only, in case of an attack, if there is no emergency room nearby)
37. /!\ Avoid Tramadol (alternative to Dafalgan Codeine), as too many people react very badly to it: nausea, drowsiness, seizures, euphoria, highly addictive, etc.

Oxalate in stone disease

1. Oxalate is an organic salt with the chemical formula C2O4
2. Its significant lithogenic (stone-forming) potential is due to its very low solubility
3. Indeed, the solubility of oxalate does not exceed 80 µmol/L in an aqueous medium, whereas urinary excretion of oxalate is normally 150 to 450 µmol/L per day
4. As a result, urine is often supersaturated with calcium oxalate, with a risk of stone formation
5. (i) It may be due to calcification in the kidney
6. /!\ It may be due to diet

Toxic effects of oxalates

1. Ingestion of 4 to 5 g of oxalate is the minimum dose capable of causing death in an adult
2. Reports have shown that 10 to 15 g is the usual amount required to cause death
3. Ingestion of oxalic acid results in corrosion of the mouth and gastrointestinal tract, gastric hemorrhage, renal failure, and hematuria
4. (i) Although sorrel is an herb and not normally consumed in large quantities, a case of fatal oxalate poisoning has been reported after a man consumed approximately 6 to 8 g of oxalate in a vegetable soup containing 500 g of sorrel
5. /!\ Experiments involving the consumption by eight women of more than 30 to 35 g/day of cocoa, a rich food in oxalate, caused symptoms of poisoning including loss of appetite, nausea and headache

Diet

1. /!\ Excess calcium, salt, sugar, animal protein, oxalate, and uric acid promote stone formation
2. Beverages
3. 2 liters per day, spread out over the day and night + 2 glasses of orange juice
4. Calcium
5. 800 to 1000 mg per day
6. Protein
7. No more than 150 g of meat or fish
8. Salt
9. Never add salt at the table
10. Oxalate
11. Avoid foods high in oxalate: chocolate, cocoa, and peanuts
12. Uric Acid
13. Avoid processed meats, offal, and game
14. Sugars
15. Avoid sweets, candies, pastries, and sodas
16. Maintain regular physical activity
17. Avoid excess calories
18. Vary your diet and consume fiber (fruits and vegetables)
19. (i) Water for babies is generally good, as it is low in minerals, such as "Mont Roucous"

Some additional tips

1. > Drink sufficient fluids
2. The goal is to increase the amount of urine you excrete in order to lower the concentration of substances that promote stone formation, such as sodium, calcium, and oxalates, in your urine
3. (i) Aim for 2 L per day, more if it's hot and/or if you exercise
4. /!\ Choose water as much as possible, as sugary drinks can increase the risk of stone formation
5. > Drink all the time
6. Every day, spreading your drinks evenly throughout the day
7. Because the goal is to prevent stone formation through stagnation
8. (i) If your urine is almost clear, it's a sign that you're drinking enough
9. /!\ Even if you wake up at night, it's better to wake up to urinate at night than to risk an attack (renal colic)
10. > Make changes to your diet
11. This isn't a diet, but rather an adjustment to your eating habits
12. Choose fruits and vegetables more often to increase your intake of potassium (bananas), magnesium, and citrate, alkaline (basic) elements that balance urine pH
13. Make sure vegetables make up half of your meal and eat fruit as a snack
14. Add lemon juice to your drinking water to increase the citric acid content of your urine
15. Consume foods high in oxalates less often and in smaller amounts
16. Oxalates and calcium attract each other; eating foods that are sources of calcium with your meals will help reduce oxalate absorption
17. (i) They bind in our stomach (rather than in our kidneys), which helps prevent the risk of stone formation
18. /!\ It is better to favor calcium from food sources, rather than taking dietary supplements
19. Eat the right amount and type of protein
20. /!\ Consuming too much animal protein can saturate the kidneys with uric acid and lead to the formation of kidney stones
21. Limit your sodium intake
22. (i) Try not to consume more than 2,300 mg of sodium per day
23. /!\ Do not add salt to your food, as excessive salt intake increases the calcium content of urine and alters its osmolarity
24. > Avoid dietary supplements
25. The presence of large amounts of calcium, vitamin D, and vitamin C in our urine can contribute to an increased risk of kidney stone formation

Warning

1. This is only a summary of research, and it has been centralized in an intuitive format to facilitate daily use
2. (i) Under no circumstances should the information on this page be taken as definitive
3. /!\ Consult a specialized doctor and seek follow-up care

Table of food

1. https://canan.me/oxalate