Renal lithiasis Stones (calculi) in the kidney

Urinary lithiasis is one of the most frequent pathologies today, with its prevalence increasing worldwide (around 37% in the last two decades). It is estimated that the approximate risk of a person forming a calculation over a lifetime is 10%. The prevalence is two to three times higher in males, with a peak incidence between the fourth and sixth decades of life.

The main risk factor for the development of lithiasis is reduced fluid intake. Eating habits, obesity, diabetes and the metabolic syndrome are also relevant risk factors. The incidence of lithiasis has an important family pattern, and several genetic alterations have been described that condition an increased risk of lithiasis formation. According to the biochemical composition, the main types of kidney stones are calcium and uric acid.

The clinical presentation of renal lithiasis is highly variable: it can be completely asymptomatic, or be responsible for recurrent urinary infections or cause renal colic. The main factors that condition the symptomatic picture of renal lithiasis are the location, size and presence of obstruction or infection.

The diagnosis is usually made through imaging exams such as the urinary tract X-ray, renal ultrasound and bladder ultrasound or abdominal and pelvic computed tomography (Uro-CT).

Small kidney stones, without associated obstruction or infection, may eventually be monitored. When necessary, the treatment of kidney stones may include medication, extra-corporal lithotripsy by shock waves, endoscopic surgery with LASER, percutaneous surgery, laparoscopic surgery or open surgery. Currently, the vast majority of kidney stones are treated using minimally invasive techniques.

The prevention of recurrence of renal lithiasis is based on increased fluid intake, a balanced diet, the adoption of a healthy lifestyle and specific measures depending on the biochemical composition of the stones.