Recurrent renal colic may be a reflection of a generalized disease of the body, not just of the kidney. Although the chances of suffering from it can be determined by different factors, it can be considerably reduced with a healthy lifestyle and proper hydration and nutrition.
What is a nephritic colic or urinary calculus and risk factors
A nephritic colic is a painful condition caused by the passage of a urinary calculus. The formation of these stones may be due to specific circumstances (therefore, not repeated) or may be a reflection of a generalized disease of the body, the kidneys or their tracts.
Among the general risk factors we find the most important ones:
– Overweight or obesity
– Hypertension
– Diabetes
– Incorrect hydration: Low intake of water or sugary drinks.
– Incorrect diet: Excess protein or sodium in the diet.
Possibility of suffering from nephritic colic.
The current way of life is causing this disease to increase its presence. Approximately 10 out of every 100 men and 7 out of every 100 women will suffer from it during their lifetime. It is even believed that this figure could be lower than the real one, due to the possibility of suffering from urinary stones in an indolent way or without the need to go to a health center and, therefore, not being diagnosed.
If an episode has already occurred, it may recur, unlike other diseases (appendicitis, for example). Thus, the risk of forming another lithiasis is 50% in the following 10 years.
Prevention and treatment of recurrent renal colic
The effort to prevent its appearance will have to be made on the patient integrally (diet, lifestyle and other associated diseases) and not only based on the results of radiological and/or analytical tests.
There are multiple pharmacological treatments in Urology to prevent the appearance of Lithiasis. Due to the existing clinical and bibliographic evidence, they require specific analytical tests, known as metabolic study, prior to their indication. In this study most of the diseases that may predispose to stone recurrence are investigated, such as alterations in calcium metabolism (hyperparathyroidism) or urine composition (hypercalciuria, hypocitraturia, hyperuricosuria…).
Each of these diseases has a different treatment. In addition to the analytical studies, the determination of the composition of the calculus, whenever possible, will complement the decision of the appropriate medication.
It is important to note that the initiation of these treatments does not exclude the dietary changes that will have been previously recommended, thus deepening the concept of the need for a general change in lifestyle habits, for the effective prevention of new episodes, and not taking yet another daily pill.
Medical approach to a patient with recurrent renal colic
For a complete evaluation of this type of disease, the following aspects should be considered simultaneously in a sequential manner:
1) Comprehensive assessment of the lithiasic problem:
– Lithiasic load: number and size of stones present in both kidneys and urinary tract.
– Alterations in the function of the urinary system, present initially or secondary to damage caused by previous expulsive episodes.
2) Dietary and lifestyle study, focused on the evaluation of the risk of recurrence of new calculi:
– Quantity and distribution of liquids ingested during the day.
– Quantity and quality of food ingested
– Risk habits or activities
3) Analysis of stone composition (if possible): this is usually performed by infrared spectroscopy, a highly reliable technique.
4) Basic or complete metabolic study (depending on the previous evaluations): Consists of a blood test associated with a 24-hour urine test. It analyzes the abnormal presence of the components involved in stone formation.
The initiation of targeted therapies according to these results has been shown to be more effective than other less specific treatments.