Kidney stones are stones that occur in the renal calyces, renal pelvis, and the junction of the renal pelvis and ureter. Parenchymal stones are rare. X-rays show single or multiple round, oval or obtuse triangular shadows with high and uniform density in the kidney area. The edges are mostly smooth, but some are not smooth and mulberry-shaped. The etiology and stone formation mechanism of kidney stones are still not completely elucidated, and may be related to dietary habits, genetics, abnormal body metabolism, medications and concomitant diseases. Types and characteristics of kidney stones According to the composition of stones, kidney stones can be divided into six categories: calcium oxalate stones, calcium phosphate stones, uric acid (urate) stones, magnesium ammonium phosphate stones, cystine stones and purine stones. Most stones can be mixed with two or more components. The characteristics of various stones are as follows: 1. Calcium oxalate stones: 80% to 84% of the stones, often yellowish brown or stone copper color, smooth surface (calcium oxalate monohydrate), rough (calcium oxalate dihydrate), male onset is more common, mostly family history, clearly visible on x-ray. There are often calcium oxalate crystals in the urine sediment. 2, calcium phosphate stones: accounting for 6% to 9% of the stones, stones are white, rough surface, often antler-shaped, hard texture. Often formed in alkaline urine. It is common in young and strong males, mostly with family history, and is clearly visible on X-ray. 3, uric acid (urate) stones: 6% to 10% of the stones, smooth surface, often antler-shaped, yellow or brown, hard texture, blurred on X-ray or can not appear. They are more common in men, especially in gout patients, and usually have a family history. Uric acid crystals can be seen in the urine sediment. 4, magnesium ammonium phosphate stones: accounting for 6% to 9% of the stones, stones yellow or dirty gray, dendritic or antler-shaped, soft texture. To women are more common, more patients with urinary tract infection, not through the X-ray. The urine sediment can be seen in the magnesium ammonium phosphate crystals. 5, cystine stones: less than 2% of stones, yellow or white stones, smooth surface, round, not easy to pass X-ray, often formed in acidic urine. Cystine crystals can be seen in the urine sediment. 6. Xanthine stones: these stones are rare, white or yellowish brown in color, brittle in texture, cannot pass through X-rays, and are usually formed in acidic urine. Clinical manifestations 1. Clinical manifestations vary greatly, depending on the etiology, composition, size, number, location, mobility, presence of obstructive infection, and the degree of parenchymal damage. In mild cases, there may be no symptoms at all, or only the discomfort of lumbar soreness, but in severe cases, anuria, renal failure, toxic shock or even death may occur. When the stone is embedded in the ureteral junction or ureter, renal colic may occur, which is a sudden onset of paroxysmal knife-like pain, the pain is severe and unbearable, the patient is restless, the pain radiates downward from the waist or lateral abdomen to the bladder area, vulva and inner thighs, sometimes with profuse sweating, nausea and vomiting. 3. Due to the heavy damage to the mucosa caused by the stone, there is often hematuria. Pain and hematuria are often induced when the patient is more active. When the stone is complicated by infection, pus cells appear in the urine and there are symptoms of frequent and painful urination. 4. When secondary to acute pyelonephritis or pus accumulation in the kidney, there may be systemic symptoms such as fever, chills and shivering. When bilateral upper urinary tract stones or kidney stones are completely obstructed, it may lead to anuria. Treatment measures: Kidney stone treatment includes surgery and non-surgical treatment. The indications for surgical treatment include: ① recurrent renal colic, kidney stones estimated to be unable to be expelled or dissolved, with a diameter of more than 1 cm; ② combined with severe obstruction, serious infection endangering the renal parenchyma. Urinary tract infection and obstruction are causal, and the stone can grow rapidly in the presence of obstruction and infection, forming a large antler-shaped stone within a few weeks. In all these cases, surgery should be performed as soon as possible to remove the stone, correct the obstruction and control the infection. If surgery is delayed when indicated, there is a high recurrence rate of the stone and even loss of kidney function after surgery. Non-surgical treatment (conservative treatment) is generally suitable for those with stones less than 1 cm in diameter, smooth periphery, no obvious urinary flow obstruction and infection. It includes the following aspects: 1. dietary treatment (1) intake of large amounts of liquid, at least 2000-3000ml of water daily, in addition to drinking a lot of water during the day, also need to drink 500ml of water before going to bed, and 200ml of water at night after getting up to urinate. water has a diuretic effect, a lot of water can increase the volume of urine, dilute the concentration of solid salts in the urine, to prevent urine salts continue to deposit on the stone to make it larger; at the same time, the At the same time, the secretion of large amounts of urine stimulates the smooth muscle of the renal calyces, renal pelvis and ureteral walls to increase peristalsis, prompting the discharge of stones. Although fruit juices and soups can be used as auxiliary drinks, water is still the best choice for hydrating the body. Patients with kidney stones should not drink milk before going to bed, this is because milk contains more calcium, and most of the kidney stones contain calcium salts. The most dangerous factor for stone formation is the sudden increase of calcium concentration in the urine for a short period of time. Two to three hours after drinking milk, it is the peak of calcium elimination through the kidneys, so when it is in a sleep state, urine concentration, calcium through the kidneys more, more weight stone formation. (2) Reduce the intake of protein, including meat, cheese, fish and chicken; avoid excessive calcium intake, but not forbidden. The incidence of oxalic acid stones accounts for the majority of urolithiasis and requires limiting the intake of foods high in oxalic acid, ethanoic acid and calcium. For example: spinach, potatoes, beets, asparagus, rape, squash, sherbet, walnuts, hazelnuts, plums, strawberries, oranges, carrots, beans, celery, cucumbers, chocolate, strong tea (black tea), kelp, shrimp, scallops, and sugar are high oxalic acid foods. Green grapes, limes, shiitake mushrooms, beets, walnuts, spinach, pears, tomatoes, and white potatoes are high ethanolic acid foods. Milk powder is a high calcium food. For stone combined with gout, meat should be restricted, animal offal should be avoided, and daily protein intake should not exceed 90g; eat less spinach, shiitake mushrooms and cauliflower, and more fruits. Alkalinization of urine is important in the prevention and treatment of uric acid stones. It is advisable to choose alkaline vegetables and fruits to keep the pH of urine in the range of 6.2 to 6.5. High calcium urinary stones with low calcium foods as a preventive and therapeutic method can reduce the incidence and prevent recurrence. It has been reported that taking 10～24g of defatted rice bran daily for 4 weeks～2 months and limiting calcium intake to 700mg per day can reduce calcium intake by using the phosphate containing phytic acid in rice bran combined with calcium. (3) eat foods rich in vitamin A, can maintain the health of the lining of the urethra, also help to avoid the recurrence of stones, such foods include: carrots, green cauliflower, cantaloupe, fenugreek, beef liver, but high doses of vitamin A is toxic, it is best to consult a doctor before taking. (4) Reduce the intake of salt and eat less of various foods high in salt. Limit the amount of vitamin C, especially for patients with calcium oxalate stones. 2.Chinese medicine treatment Kidney stone belongs to the category of “stone shower” in Chinese medicine, most of them are treated by clearing dampness and heat and draining stones. grams, licorice 6 grams. If there is blood in the urine, add small thistle, raw earth and lotus root to cool the blood and stop bleeding. There are many kinds of lithotripsy and lithotripsy remedies, but they should be used under the guidance of a doctor. 3.Other activities Jumping activities, or inversion of the stone in the kidney calyx and tapping activities, to promote the stone to move and fall, which is conducive to stone discharge. For those who have bacterial infection in urine culture, choose sensitive antibiotics to actively anti-infection, for those who have metabolic disorder in body, should actively treat the primary disease and adjust the pH of urine, etc.