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Calculos renales
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Calculos renales

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Cálculos Renales.

Los cálculos renales también conocidos como litiasis renal, son masas duras como una piedra que se forman principalmente por la saturación de sales en la orina y otras sustancias como el calcio y el ácido úrico en los riñones o las vías urinarias. Su tamaño puede variar desde 1 milímetro hasta 3 cm o más de diámetro, los más pequeños no producen molestia alguna; sin embargo, los mayores causan dolor intenso en la parte baja de la espalda que irradia hasta el abdomen y la pelvis.

Causas

Entre los factores que promueven la formación de los cálculos se pueden citar:

Excesiva pérdida de líquido a través del sudor.
Poca ingestión de agua.
Dieta alta en proteínas.
Exceso de suplementos de calcio o de bicarbonato de sodio.
Ciertos trastornos metabólicos.
Infecciones en las vías urinarias como: cistitis, uretritis, pielonefritis y ureteritis.
 
Síntomas

Los cálculos renales pueden provocar diversos síntomas, dependiendo de su tamaño, composición y situación dentro del aparato urinario. Generalmente, los más pequeños no producen síntomas y en ocasiones son descubiertos por casualidad mientras se están formando a través de un análisis de orina.
 
 
 
Aquellos de mayor tamaño ocasionan síndromes específicos:

Cólico nefrítico: Los cálculos del riñón pueden producir una obstrucción en la salida de la orina produciendo un intenso dolor que aparece en la zona renal (lumbar o espalda baja) y se irradia hacia el abdomen y los genitales. Es un dolor intermitente y el paciente no encuentra ninguna postura que le alivie; se asocia a nauseas, vómito, sudoración y sensación de hinchazón abdominal.

Dolor lumbar: Es ocasiones el dolor de los cálculos es menor. Suele ser fijo y continuo en la zona lumbar, que es la que recubre los riñones. Este dolor se puede confundir con los dolores de origen reumático de los huesos y articulaciones.

Hematuria: Es la aparición de sangre en la orina, la cual puede ser visible a simple vista, o por el contrario puede apreciarse únicamente mediante un análisis microscópico. La hematuria aparece debido a las pequeñas heridas que produce el cálculo a su paso por el interior del riñón.

Infecciones urinarias: Por su situación, algunos cálculos solo se manifiestan por la aparición de infecciones, ya sea de la vejiga o del propio riñón.

Diagnóstico

El dolor causado por los cálculos renales suele ser intenso, por lo que la mayoría de los enfermos procuran inmediatamente acudir al médico. Los síntomas que requieren de exploración médica son:

Orina turbia o con olor desagradable.
Fiebre.
Escalofríos.
Debilidad.
Para que el médico realice un diagnóstico adecuado, es necesario conocer la ubicación y el tamaño de los cálculos, su composición y la posible existencia de enfermedades que se asocien a su formación.

La ubicación y el tamaño se determinan mediante:

Radiografías
Urografías
Ecografías
La composición de los cálculos expulsados se determina mediante análisis específicos y posteriormente, se estudia la presencia de enfermedades asociadas.

Tratamiento

Según el tipo de cálculo, se prescribe el tratamiento adecuado:

Cuando los cálculos son pequeños, no causan síntomas ni provocan infecciones por lo que no suelen ser tratados, sin embargo, es recomendable beber abundantes líquidos para favorecer la producción de orina que arrastre las piedras o arenillas.
Los cálculos menores a un centímetro pueden eliminarse según la zona donde se encuentren, con ondas de ultrasonido que los pulveriza y los arrastra con la orina al exterior.
Para cálculos más grandes que obstruyen una vía urinaria suele ser necesaria la intervención quirúrgica para extirparlos.
Una técnica nueva consiste en romper los cálculos en trozos pequeños usando ondas sonoras. Esta técnica se conoce como litotricia.

Prevención

El mejor de los cuidados para esta enfermedad es su prevención. Esta puede realizarse de la siguiente manera:

Beber 3 litros de líquido al día.
Mantener una dieta baja en calcio, sal y proteínas tales como carne roja y pescado, ya que estos alimentos propician concentración de ácido úrico en la orina.
Evitar cualquier infección urinaria y en caso de tenerla acudir al médico para tratarla correctamente y así evitar un problema mayor. mediks
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