What causes kidney stones? - Arash Shadman

Prevodilac: Ivana Krivokuća Lektor: Tijana Mihajlović

Najveći zabeleženi kamen u bubregu težio je više od jednog kilograma

The biggest kidney stone on record weighed more than a kilogram

and was 17 centimeters in diameter.

i bio je prečnika od 17 centimetara.

The patient didn't actually swallow a stone the size of a coconut.

Pacijent zapravo nije progutao kamen veličine kokosa.

Kidney stones form inside the body,

Kamen u bubregu se formira u telu,

but unfortunately, they're extremely painful to get out.

ali ih je, nažalost, veoma bolno izbaciti.

A kidney stone is a hard mass of crystals that can form in the kidneys,

Kamen u bubregu je čvrsta masa kristala koji se mogu formirati u bubrezima,

ureters,

mokraćovodima,

bladder,

bešici

or urethra.

ili mokraćnoj cevi.

Urine contains compounds that consist of calcium,

Urin sadrži jedinjenja koja se sastoje od kalcijuma,

sodium,

natrijuma,

potassium,

kalijuma,

oxalate,

oksalata,

uric acid,

mokraće kiseline

and phosphate.

i fosfata.

If the levels of these particles get too high,

Ako nivo ovih čestica postane preveliki

or if urine becomes too acidic or basic,

ili ako urin postane previše kiseo ili bazičan,

the particles can clump together and crystallize.

čestice mogu da se grupišu i kristališu.

Unless the problem is addressed,

Ukoliko se taj problem ne reši,

the crystals will gradually grow over a few weeks, months, or even years,

kristali će postepeno rasti

tokom nekoliko nedelja, meseci, pa čak i godina,

forming a detectable stone.

formirajući primetan kamen.

Kalcijum oksalat je najčešći tip kristala koji se formira na ovaj način

Calcium oxalate is the most common type of crystal to form this way,

and accounts for about 80% of kidney stones.

i čini oko 80% kamena u bubregu.

Less common kidney stones are made of calcium phosphate, or uric acid.

Manje učestalo kamenje u bubregu sačinjava kalcijum fosfat ili mokraćna kiselina.

A slightly different type of stone

Malo drugačiju vrstu kamena

made of the minerals magnesium ammonium phosphate, or struvite,

sačinjenu od minerala magnezijum-amonijum-fosfata ili struvita

can be caused by bacterial infection.

može uzrokovati bakterijska infekcija.

And even rarer stones can result from genetic disorders

Još ređi kamenovi mogu biti posledica genetskih poremećaja

ili izvesnih lekova.

or certain medications.

A kidney stone can go undetected until it starts to move.

Kamen u bubregu može biti neprimećen dok ne počne da se pomera.

Kada kamen putuje kroz bubreg i u mokraćovod,

When a stone travels through the kidney and into the ureter,

its sharp edges scratch the walls of the urinary tract.

njegove oštre ivice grebu zidove urinarnog trakta.

Nerve endings embedded in this tissue transmit excruciating pain signals

Nervni završeci ugrađeni u ovo tkivo prenose mučne signale za bol

through the nervous system.

kroz nervnih sistem.

And the scratches can send blood flowing into the urine.

A te ogrebotine mogu oslobađati krv u mokraću.

To može biti praćeno simptomima mučnine,

This can be accompanied by symptoms of nausea,

vomiting,

povraćanja

and a burning sensation while urinating.

i osećaja peckanja pri mokrenju.

Ako kamen postane toliko veliki da blokira protok mokraće,

If a stone gets big enough to actually block the flow of urine,

it can create an infection, or back flow,

može stvoriti infekciju ili povratni tok

and damage the kidneys themselves.

i da ošteti same bubrege.

But most kidney stones don't become this serious,

Većina kamena u bubregu ne postane toliko ozbiljna

niti zahteva invazivno lečenje.

or even require invasive treatment.

Masses less than five millimeters in diameter

Oni koji imaju manje od pet milimetara u prečniku

will usually pass out of the body on their own.

obično će sami izaći iz tela.

A doctor will often simply recommend drinking large amounts of water

Doktor će često jednostavno preporučiti ispijanje velikih količina vode

to help speed the process along,

da pomogne da se ubrza proces,

and maybe taking some pain killers.

i možda uzimanje lekova protiv bolova.

If the stone is slightly larger, medications like alpha blockers

Ako je kamen malo veći, lekovi poput alfa blokatora

can help by relaxing the muscles in the ureter

mogu pomoći opuštanjem mišića u mokraćovodu

and making it easier for the stone to get through.

i olakšavanjem prolaska kamenu.

Another medication called potassium citrate

Drugi lek zvani kalijum citrat

can help dissolve the stones by creating a less acidic urine.

može pomoći da se kamenovi rastvore stvarajući urin smanjene kiselosti.

For medium-sized stones up to about ten millimeters,

Za kamenove srednje veličine do deset milimetara,

one option is pulverizing them with soundwaves.

jedna od opcija je njihovo pretvaranje u prah pomoću zvučnih talasa.

Extracorporeal shock wave lithotripsy uses high-intensity pulses

Ekstrakorporalna litotripsija udarnim talasima

koristi visoko intenzivne impulse

fokusirane ultrazvučne energije koja je direktno usmerena na kamen.

of focused ultrasonic energy aimed directly at the stone.

The pulses create vibrations inside the stone itself

Impulsi stvaraju vibracije unutar samog kamena

and small bubbles jostle it.

i mehurići ga istiskuju.

Kombinacija ovih sila lomi kamen u manje delove

These combined forces crush the stone into smaller pieces

koje je lakše izbaciti iz tela.

that can pass out of the body more easily.

But zapping a stone with sound doesn't work as well

Ali, uništavanje kamena zvukom ne deluje tako dobro

if it's simply too big.

ako je jednostavno prevelik.

So sometimes, more invasive treatments are necessary.

Zato su ponekad neophodni invazivniji tretmani.

Kruta cev zvana stent se može postaviti u mokraćovod da bi ga proširila.

A rigid tube called a stent can be placed in the ureter to expand it.

Optička vlakna mogu primenjivati laserske impulse da razbiju kamen.

Optical fibers can deliver laser pulses to break up the stone.

Stones can also be surgically removed through an incision

Kamen se takođe može hirurški ukloniti zasecanjem

in the patient's back or groin.

u predelu pacijentovih leđa ili prepona.

What about just avoiding kidney stones in the first place?

A šta je, pre svega, sa izbegavanjem kamena u bubregu?

For people prone to them,

Ljudima koji su im skloni

their doctor may recommend drinking plenty of water,

doktor može preporučiti da piju puno vode,

which dilutes the calcium oxalate and other compounds

što razređuje kalcijum oksalat i druga jedinjenja

that eventually build up into painful stones.

koja vremenom izgrađuju bolno kamenje.

Foods like potato chips,

Hrana kao što je čips,

spinach,

spanać,

rhubarb,

rabarbara

and beets are high in oxalate,

i cvekla imaju visok sadržaj oksalata,

so doctors might advise limiting them.

pa doktori mogu savetovati da se ograniči njihov unos.

Even though calcium is often found in stones,

Iako se kalcijum često nalazi u kamenju,

calcium in foods and beverages can actually help

kalcijum u hrani i piću zapravo može pomoći

vezivanjem za oksalat u digestivnom traktu

by binding to oxalate in the digestive tract

pre nego što se apsorbuje i stigne do bubrega.

before it can be absorbed and reach the kidneys.

Ako na kraju dobijete kamen u bubregu, niste sami.

If you do end up with a kidney stone, you're not alone.

Data suggests that rates are rising,

Podaci ukazuju na to da učestalost raste,

but that world record probably won't be broken any time soon.

ali onaj svetski rekord verovatno neće skoro biti srušen.