Types Of Kidney Stones
There are four major types of kidney stones, including:
- stones formed from calcium not used by the bones and muscles, combined with oxalate or phosphate these are the most common kidney stones
- stones containing magnesium and the waste product ammonia these are called struvite stones and form after urine infections
- uric acid stones these are often caused by eating very large amounts of protein foods
- cystine stones these are rare and hereditary.
Proteinuria: What Is It And What Does It Mean
Your blood is made up of nutrients that you consume through fats, proteins, and carbohydrates. Its how our body gets energy and continues to function throughout the day. Protein plays an important role in keeping your body strong by building bones and muscles, preventing infection, and controlling the amount of fluid in your blood.1When you have a healthy urinary tract system, your kidneys work to filter your blood through small pathways of capillaries within the kidney structure. This filtering process removes waste and extra fluid but leaves proteins and other nutrients so they can be used throughout the body.1 When your kidneys are working properly, protein doesnt pass into your urine. When your kidneys arent working properly, protein bypasses the filtration process and winds up in your urine.1 This is called proteinuria. In this article well dive into answering the questions surrounding proteinuria: what is it and what does it mean?
How Common is Proteinuria?
What Does it Mean?
Proteinuria can be an indication of serious problems like kidney damage. When protein is able to get into your urine, it means that the filtration process is not working properly in your kidneys. It could either be damage to the glomeruli or damage to tubules that work as secondary filtration mechanisms.2 Either way, proteinuria means that youre likely suffering from some degree of kidney damage.
Different Types of Proteinuria
Causes of Proteinuria
Symptoms of Proteinuria
Protein In Urine Symptoms
Most people who have proteinuria wonât notice any signs, especially in early or mild cases. Over time, as it gets worse, you might have symptoms including:
- Foamy or bubbly pee
- A family history of kidney disease
- African American, Native American, Hispanic, or Pacific Islander descent
Some people get more protein into their urine while standing than while lying down. This condition is called orthostatic proteinuria.
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Impact Of Renal Stones On Pregnancy
Presence of renal stones in pregnant women has been associated with a significant increase in the risk of recurrent miscarriage, mild pre-eclampsia, chronic hypertension, gestational diabetes mellitus, and caesarean deliveries.26,27 It has also been associated with premature rupture of membranes in one study.23 Preterm delivery rates ranging between 2.5 and 40% have been reported.17,18,20,23,27 However, these findings are not seen consistently among different studies. Although an association with low birthweight has been reported in one study,27 most studies do not report increased risks for the baby, including risk of congenital malformations, low birthweight, low Apgar scores, and perinatal death.23,26,28 As data are conflicting among the different studies, the true risks of renal stones on pregnancy outcomes are difficult to ascertain.
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How Will I Know If I Have Protein In My Urine
The only way to know if you have protein in your urine is to have a urine test. The test will measure the levels of protein in your urine.
The name of the urine test that measures the level of albumin in your urine is called the urine albumin-to-creatinine ratio . A UACR compares the level of albumin to the level of creatinine . A normal UACR is less than 30mg/g. If your UACR is 30 mg/g or higher, it can be a sign of kidney disease, and you should ask your doctor if you should have other tests of kidney disease.
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Prevention Of Future Stones
Once your health care provider finds out why you are forming stones, he or she will give you tips on how to prevent them. This may include changing your diet and taking certain medications. There is no “one-size-fits-all” diet for preventing kidney stones. Everyone is different. Your diet may not be causing your stones to form. But there are dietary changes that you can make to stop stones from continuing to form.
Drink enough fluids each day.
If you are not producing enough urine, your health care provider will recommend you drink at least 3 liters of liquid each day. This equals about 3 quarts . This is a great way to lower your risk of forming new stones. Remember to drink more to replace fluids lost when you sweat from exercise or in hot weather. All fluids count toward your fluid intake. But it’s best to drink mostly no-calorie or low-calorie drinks. This may mean limiting sugar-sweetened or alcoholic drinks.
Knowing how much you drink during the day can help you understand how much you need to drink to produce 2.5 liters of urine. Use a household measuring cup to measure how much liquid you drink for a day or two. Drink from bottles or cans with the fluid ounces listed on the label. Keep a log, and add up the ounces at the end of the day or 24-hour period. Use this total to be sure you are reaching your daily target urine amount of at least 85 ounces of urine daily.
Reduce the amount of salt in your diet.
Eat the recommended amount of calcium.
How Is A Urine Test Done
A simple urine test can be done in your doctor’s office. You will be asked to pee into a clean cup called a specimen cup. Only a small amount of your urine is needed to do the test. Some of the urine is tested right away with a dipstick a thin, plastic strip that is placed in the urine. The rest is examined under a microscope.
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How Can I Slow The Damage To My Kidneys
Damage to your kidneys cannot be reversed, but you can keep it from getting worse. By following your treatment plan and making healthy life changes, you can help keep your kidneys working for as long as possible.
Take these steps to slow the damage to your kidneys:
- Work with your doctor to manage diabetes and high blood pressure.
- Take all of your prescription medicines as your doctor tells you.
- Have visits with a kidney doctor to check your blood levels and overall health.
- Follow a kidney-friendly eating plan. A dietitian can help you make a plan that works for you.
- Be active for 30 minutes most days of the week.
- Drink less alcohol. The healthy guidelines for drinking alcohol are:
- For men: No more than two drinks per day
- For women: No more than one drink per day
Can Having An Ectopic Pregnancy Affect Future Fertility
In terms of future fertility, those who experience an ectopic pregnancy shouldnt be too concerned, even if you have a fallopian tube removed. As long as both of the ovaries are still there, and the other tube is healthy, then a woman should still be able to get pregnant with just one fallopian tube.
A number of tests can help find duplicated ureters:
- Ultrasound of your kidneys and bladder can show if there is a duplicate system.
- Computed tomography : Multiple scans are assembled into a three-dimensional image of a body structure.
- Magnetic resonance imaging : An injected liquid dye is traced to show how your kidneys and urinary system function.
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Pregnancy And Urinary Tract Infections
During pregnancy, there are normal changes in the function and anatomy of the urinary tract. These include kidney enlargement, and compression of the ureters and bladder by the growing uterus. During pregnancy, the bladder does not empty as well. The urine is not as acidic and it contains more sugars, protein, and hormones. All of these factors can contribute to an increased susceptibility to UTI.
Types of UTI in pregnancy include the following:
Asymptomatic bacteriuria. A silent infection often caused by bacteria present in the womans system before pregnancy. This type of infection occurs in about 5 to 10 percent of pregnant women. Asymptomatic bacteriuria may lead to acute bladder infection or kidney infection if left untreated.
Acute urethritis or cystitis. A urethral or bladder infection that causes symptoms including pain or burning with urination, frequent urination, feeling of needing to urinate, and fever.
Pyelonephritis. A kidney infection. Symptoms of pyelonephritis may include those of acute cystitis plus flank pain. Pyelonephritis may lead to preterm labor, severe infection, and adult respiratory distress syndrome.
The most common organism that causes UTI is Escherichia coli , a normal organism of the vagina and rectal area. Other organisms may also cause UTI, including group B streptococcus, and sexually transmitted gonorrhea and chlamydia.
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What Are Kidney Stones
Usually, your kidneys remove waste from your blood to make urine . When there is too much waste in your blood and your body is not producing enough urine, crystals begin to form in your kidneys. These crystals attract other wastes and chemicals to form a solid object that will get larger unless it is passed out of your body in your urine.
Kidney stones can be as small as a grain of sand or as large as a golf ball.
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How Can One Prevent Kidney Stones
The easiest and likely the only way to prevent risks of kidney stones is by introducing tangible lifestyle changes. Some of them are:
- If you have a habit of staying dehydrated throughout the day, ensure that you drink enough water throughout the day. Ideally, drinking a minimum of 2 liters of water is considered ideal.
- Reduce the consumption of oxalate-rich foods, including nuts, teas, leafy greens like spinach, Swiss chard, etc. These are some of the best foods to avoid kidney stones.
- Switch to a diet low in salt, and protein-rich foods, both from protein and non-animal proteins.
- Dont cut out the calcium-rich foods completely, but at the same time, get rid of calcium supplements from the diet. Several calcium supplements are found to contribute to the risks of kidney stones in the body.
If your doctor thinks your diet is a major contributing factor, your doctor might refer you to a dietician to get your eating habits back on track.
Treating And Preventing Kidney Stones
Most kidney stones are small enough to be passed in your urine, and it may be possible to treat the symptoms at home with medication.
Larger stones may need to be broken up using ultrasound or laser energy. Occasionally, keyhole surgery may be needed to remove very large kidney stones directly.
Read more about treating kidney stones.
Itâs estimated that up to half of all people who have had kidney stones will experience them again within the following five years.
To avoid getting kidney stones, make sure you drink plenty of water every day so you donât become dehydrated. Itâs very important to keep your urine diluted to prevent waste products forming into kidney stones.
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Protein In Urine Diagnosis
A urine test called a urinalysis can tell whether you have too much protein in your pee. First, youâll pee into a cup. A lab technician will dip in a stick with chemicals on the end. If the stick changes color, itâs a sign of too much protein. You might need to have this test more than once to find out how long the protein is there.
The technician will also look at the pee under a microscope. Theyâre checking for things that shouldnât be there, which might mean kidney problems. These include red and white blood cells, crystals, and bacteria.
If your doctor suspects kidney disease, you might need to have other urine tests. Your doctor might also order:
- Blood tests. These measure certain chemicals to check how well your kidneys are working.
- Imaging tests. CT scans and ultrasounds can spot kidney stones, tumors, or other blockages.
- A kidney biopsy. Your doctor might need to take a small sample of kidney tissue so a lab technician can look at it under a microscope.
Causes Of Kidney Stones
Potential causes embrace ingesting too little water, train , weight problems, weight reduction surgical procedure, or consuming meals with an excessive amount of salt or sugar. Infections and household historical past is perhaps essential in some folks. Consuming an excessive amount of fructose correlates with growing threat of creating a kidney stone. Fructose might be present in desk sugar and excessive fructose corn syrup.
There are 4 fundamental kinds of stones:
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Kidney Stone Signs Protein In Urine And Kidney Stones
Some kidney stones are as small as a grain of sand. Others are as giant as a pebble. A couple of are as giant as a golf ball! As a common rule, the bigger the stone, the extra noticeable are the signs.
The signs could possibly be a number of of the next:
The kidney stone begins to harm when it causes irritation or blockage. This builds quickly to excessive ache. Most often, kidney stones go with out inflicting damage-but normally not with out inflicting loads of ache. Ache relievers often is the solely therapy wanted for small stones. Different therapy could also be wanted, particularly for these stones that trigger lasting signs or different issues. In extreme circumstances, nevertheless, surgical procedure could also be required.
How Much Protein Do We Need
A subsequent WHO meta analysis of mostly the same underlying data supplemented by more recent studies comes to much the same conclusions, but in perhaps a more nuanced manner. A more recent analytical critique of the whole matter is not remarkably far off in estimates for adults, though pregnancy and childhood seem controversial.
This summary graph from the critique gives a sense of how the protein requirements are set. The median requirement is where about half of all studied subjects were in neutral nitrogen balance their body protein mass would be stable, a very important matter. The safe population intake is set higher. The safe individual value is high enough enough that 97.5% of the individuals in a population would be in balance: almost all people would not lose protein mass consuming this amount of protein for example muscle. The Safe population intake is set higher. Although the safe individual intake is correct, within a population individual requirements vary, so the recommended level needs to be increased so that 97.5% of the individuals in a population offered that recommendation will be in balance.
That number from the WHO meta-analysis, the safe population intake, is about 1.05 gm/kg body weight/day.
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What Are The Symptoms Of Kidney Stones
If you have a small kidney stone, it may travel out of your body through your urine . You may not have any symptoms and may never know that you had a kidney stone.
If you have a larger kidney stone, it may get stuck in your urinary tract and block urine from getting through. You may notice symptoms, including:
- Pain while urinating
- Sharp pain in your back or lower belly area
- Stomachache that does not go away
- Feeling sick to your stomach or throwing up
- A fever and chills
- Urine that smells bad or looks cloudy
You may feel a lot of pain when you pass a kidney stone or if a large kidney stone blocks the flow of your urine.
If you are having any of these symptoms, contact your doctor.
Diagnosis Of Nephrotic Syndrome
Diagnosing nephrotic syndrome involves a number of tests, including:
- urine tests excessive protein makes the urine appear frothy and foamy. A test for albumin/creatinine ratio may be done to measure the amount of albumin in the urine in relation to the amount of creatinine
- blood tests these estimate the glomerular filtration rate , which shows how well the kidneys are working
- biopsy a small sample of kidney tissue is taken and examined in a laboratory.
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How Is Proteinuria Diagnosed
Proteinuria is diagnosed through a urine test. The patient provides a urine sample, which is examined in a lab. Doctors use a dipstick a thin plastic stick with chemicals on the tip to test part of the sample right away. If too much of any substance is in the urine, the chemical tip changes color.
The remainder of the urine is then examined under a microscope. Doctors look for substances that dont belong in urine. These substances include red and white blood cells, bacteria and crystals that can grow and develop into kidney stones.
Protein Imposes An Acid Load
For several generations we have known that the sulfur containing amino acids cystine and methionine produce an acid load and that rising diet protein acid loads correlate with increased urine calcium excretion. Giving acid loads experimentally increases urine calcium excretion.
Some believe acid loads promote bone fractures by mobilizing bone mineral stores and that alkali treatments prevent this form of bone loss. Others believe that the protein increases urine calcium by increasing intestinal calcium absorption and does not adversely affect bone,
Fenton and her colleagues performed what I think is a rigorous meta-analysis of studies available up to 2006 concerning effects of acid load on the urine calcium excretion. The acid loads were varied by variation of diet protein, and by giving acid loads like ammonium chloride a purely experimental strategy. No matter how acid load was varied urine calcium varied linearly.
The points on this graph are from Table 2 of her paper. I have redrawn her figure to suit my taste. My data set is available for others.
The negative changes in net acid load are from alkali loading such as potassium citrate. The changes from, as an example, 50 mEq of alkali the -50 position on the horizontal axis corresponds to a fall of about 50 mg/d of urine calcium.
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