What are staghorn kidney stones
Staghorn Kidney stones are struvite calculi. Such calculi are composed of a mix of magnesium ammonium phosphate and calcium carbonate apatite. Kidney stones consisting of cystine or uric acid, either alone or in combination with other components, can also form as a staghorn or grow in a branched configuration. Calcium oxalate or phosphate stones in this configuration are rare.
Struvite or calcium carbonate apatite stones are called infection stones, due to their link with urinary tract infection resulting from specific organisms. These organisms produce the enzyme urease that facilitates generation of ammonia and hydroxide from urea. It leads to urine alkalinity and increased ammonia concentration. Accompanied with phosphate and magnesium in the urine, these enable crystallization of struvite stones.
Formation of an exopolysaccharide biofilm, along with incorporation of mucoproteins and other organic compounds, also contribute. Inspection of these stones revealed that bacteria reside within the stones resulting in the stones being infected. It is unlike other kidney stones where the stones remain free of infection. Repeated infections may lead to stone formation and once an infection stone occurs, infections tend to recur.
How can staghorn kidney stones be treated clinically
Untreated staghorn stones may result in destroying the kidneys. They may also lead to life – threatening sepsis. To preserve the kidney functions, eradicating the stones completely ensures elimination of offending organisms, ease obstructions, inhibit further stone formation and accompanying infections.
Though, some studies advocate sterilizing small residual struvite fragments and thereby limit stone activity, others indicate that residual fragments may multiply to be a source for recurrent urinary tract infections. Hence, the therapeutic objective remains to be a complete stone removal.
On the basis of the evidence, physicians treat staghorn calculi with,
– Percutaneous nephrolithotomy monotherapy
– Combination of percutaneous nephrolithotomy and shock – wave lithotripsy
– Shock – wave lithotripsy monotherapy
– Anatrophic nephrolithotomy or open surgery
Are clinical treatments successful
Primary, secondary and adjunctive procedures are involved in the treatment modalities. Primary procedures are those that aim to eliminate the stones. Secondary procedures address the associated complications. Adjunctive procedures are incidental like stent insertion or removal. Averaging out, percutaneous nephrolithotomy requires 1.9, combination therapy requires 3.3, shock – wave lithotripsy requires 3.6 and open surgery requires 1.4 total procedures.
Success rate for percutaneous nephrolithotomy monotherapy treatment is 78%. For shock – wave lithotripsy monotherapy it is 54%. The calculated rate for combination therapy is 66% and for open surgery it is 71%.
What complications can the treatment modalities lead to
The treatment modalities might lead to acute complications like significant intricacies, transfusion and fatality. The transfusion rate for percutaneous nephrolithotomy and combination therapy is less than 20%. The transfusion rate for shock – wave lithotripsy is low and may be needed in clinically significant perirenal hematomas. The transfusion rate for open surgery ranges from 20% to 25%. Fatality is rare but can occur due to sepsis or other significant acute complications.
Can staghorn kidney stones be treated naturally
A few natural remedies for curing staghorn kidney stones are,
– Apple Cider Vinegar and baking soda mix is an effective natural remedy against staghorn stones. The former cleanses internally and the latter alkalizes.
– Cereal grasses for instance wheat grass and barley grass aid in alkalizing and consequently prevent staghorn kidney stones from developing.
– Green tea is an effective natural remedy for staghorn kidney stones. The Japanese consume drink green tea regularly and rarely suffer from the malady.
– Grapes, oranges, guavas and carrots have citrates that inhibit alkalinity and thus, prevent staghorn kidney stones from forming.
– Carbonated beverages possess phosphoric acid that regulates alkalinity and restricts formation of staghorn kidney stones.
– Chanca Piedra is an herb, sourced from Peru, which fragments kidney stones and does not result in any side effects either.
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