Kidney staghorn calculus11/11/2023 I – concretion occupies the pelvis, has small processes in the renal calyx.Taking into account the size and location of the concretion in the CHLC, as well as violations of renal function, there are 4 stages of staghorn calculus: In the late stages of stone formation, gross changes in the renal parenchyma develop, which leads to the occurrence and progression of renal insufficiency. Increasing in size, the stone gradually fills the renal pelvis, one or more cups, taking a bizarre shape resembling coral or deer horn. Among other concretions there are oxalate, cystine, mixed. 75% of all coral-like stones are struvite and carbonatapatite in their chemical composition. In the future, the salt sediment crystallizes with the formation of stones consisting of calcium phosphate (apatites), magnesium-ammonium phosphate (struvites), calcium hydrogen phosphate dihydrate (brushites), etc. Calcium, ammonium, and magnesium phosphates from the urine saturated with salts settle on the organic matrix – colloidal bodies consisting of glycoproteins and glycosaminoglycans, which make up the core of the concretion. Against the background of inflammation, the discharge of mucus, exfoliated epithelium, necrotic tissues from the renal tubules becomes difficult. These microorganisms decompose urea to ammonia, causing alkalinization of urine. Hemodynamic disorders and impaired lymph outflow contribute to the development of infectious processes involving urease-producing bacteria. PathogenesisĪs a result of urodynamic disorders, intraocular pressure increases, which leads to arteriospasm, a decrease in venous tone and deterioration of kidney perfusion as a whole. hereditary predisposition (coral-like stones are present in 26% of relatives of patients).bone fractures requiring prolonged immobilization.endocrine and metabolic diseases: hyperparathyroidism, diabetes, obesity, gout.features of the drinking regime and nutrition.Risk factorsĪll other endogenous and exogenous factors, except for structural changes and infection, create conditions that significantly increase the risk of the formation of staghorn calculus: The high-risk group includes patients with chronic pyelonephritis. As a result of their enzyme activity, the pH of urine increases, conditions for stone formation are created. Patients have a history of recurrent UTIs caused by microorganisms that break down urea: P. Acquired defects that increase the risk of staghorn calculus, ureteral strictures, vesicoureteral reflux. Among the congenital anomalies, dystopian, horseshoe-shaped and spongy kidney, ureterocele are most often detected. The first condition creates anatomical prerequisites for chronic urostasis, the second one determines the alkalinization of urine, the precipitation of urinary sediment and its crystallization. The key prerequisites for the formation of this disease are congenital or acquired nephropathies (glomerulopathy, tubulopathy), as well as infections caused by urease-forming bacteria. In modern urology, the relevance of this disease is due to its high prevalence among the able-bodied population, a large percentage of complications and relapses, and the lack of uniform treatment algorithms. More than half of the patients are aged 30-50 years. Staghorn calculus are 2 times more likely to form in women. The greatest incidence is registered in tropical countries, Central Asia. Staghorn calculus is a severe variant of urolithiasis, which accounts for 5-35% of all its cases.
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