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Kidney stones may be painful, but they rarely cause a serious health condition if treated properly. The kidney stones are hard crystalline deposits of salts and minerals inside our kidneys. This condition affects every 1 among 20 people worldwide. The size of stones can range from small and unnoticeable to large ones that can cause a lot of pain and need medical intervention. Although they rarely cause permanent damage if discovered and treated in time, kidney stones can cause several complications like kidney infections and following abscess formation. Treating and preventing this condition is typically easy and includes lifestyle changes, remedies, prescription medication, or surgery in the most severe cases. In this article, we will explain how to prevent kidney stones and treat them if you are already afflicted. Table of Contents Things to Know About Kidney Stones Before we can get into the treatment and prevention of formation of kidney stones, let’s go over some important facts about this condition, including causes, risk factors, and common symptoms. What Causes Kidney Stones? To learn how we can prevent kidney stones, we first need to know more about what causes them. Kidney stones are likely to develop when there are more crystal-forming substances (oxalate, calcium, uric acid) in our urine. This usually happens when we don’t drink enough water, so the balance between these components gets disrupted and the environment in our urine becomes more acidic. Kidney Stones Risk Factors Although there isn’t a single mechanism of kidney stones formation, there are several factors that increase your chances of getting this condition. Here are some of the main risk factors: - Dehydration– people who drink less than the daily recommendation (approximately 2 liters) are at a higher risk of getting kidney stones. Drinking extra water dilutes the stone forming substances, thus preventing stone formation. The same goes for people who sweat a lot or live in warmer climates, as they are losing more fluids. - Certain diets – diets that are high in protein, sugar, and sodium (salt) all leave you at a higher risk of kidney stones. Sodium-rich diets, in particular, can increase the amount of calcium in our urine.. Current guidelines suggest restricting total daily sodium intake to 2,300 mg. - Personal or family history – you’re more likely to develop kidney stones if they affect one or more of your close relatives. The same goes for personal history – you’re more likely to get kidney stones if you’ve experienced this condition before. There is strong scientific evidence contributing to this relation. - Obesity – several markers of obesity, including high BMI (body mass index), weight gain, slower metabolism, and large waist size, have all been linked to kidney stones. The mechanism is that obesity influences insulin resistance, which causes reduced urinary ammonium excretion and thus a low urinary pH; and the consequence is a greater risk of uric acid stone formation. Common Symptoms Kidney stones can affect any part of our urinary tract — from our kidneys to our bladder. Smaller kidney stones can often be present with no symptoms at all – we eventually pass them through our urine without even feeling them. Passing larger kidney stones can be quite painful, but the stones usually cause no permanent damage if they're recognized and cured in time. But, even the bigger ones can leave the organism unnoticed until they reach the ureter. Here are some of the most common symptoms of kidney stones: - Severe pain in the back and side, below the ribs; - Pain in the spreads towards the lower abdomen; - Painful urination; - Pain fluctuating in intensity; - Pink or red urine; - Foul-smelling and cloudy urine; - Nausea and vomiting; - Constant need to urinate; - Passing small amounts of urine; and - Fever if an infection is present. Diagnosis There are several tests your doctor may perform to see if you have kidney stones. - Blood testing – your doctor may perform a blood test to check the concentration of uric acid or calcium in your bloodstream. - Urine testing – a urine collection test will show if there are too many minerals in your urine that contribute to stone formation. - Imaging – one of the most reliable methods to see if you have kidney stones is to perform radiological examination. CT scans have high resolution and can detect very small stones in comparison with traditional abdominal X-rays. - Passed stones analysis – to determine the cause of your stones, your doctor may require you to urinate through a strainer. The stones that get caught will then get analyzed to determine their origin and constitution in order to create a more reliable plan for treatment and prevention. Kidney Stones Treatment and Prevention The treatment of kidney stones is initially aimed towards combating the symptoms. As an ultimate way to overcome this condition is to pass the stones through urine. However, you can effectively dissolve kidney stones using several methods ranging from home remedies and lifestyle changes to surgery for stones, not sensitive to traditional therapies. You can also prevent this condition in a number of ways. Here are some tips on how to prevent kidney stones, as well as some treatment options often prescribed by doctors. Drink More Water As said before, dehydration is by far one of the most common causes of kidney stones. When we drink less water, the fluids in our kidneys move slower, so there is a bigger chance of salt and mineral compounds coming into contact and sticking together to form stones. This is why drinking more water should be your first step towards fighting this condition. Drinking a lot of water is crucial to keep your urine completely clear. Dark yellow or brown urine is an indicator that you’re not drinking enough water, although sometimes it can be associated with other pathological situations. You should aim for 12 glasses of water per day (standard 250ml glass). If you exercise often or live in a very hot and dry climate, you may need to drink even more because of excess water drain from your organism by other ways other than urine formation. Even when you have passed the stone, you should keep drinking 12 glasses of water per day. Since you’re at a higher risk to get kidney stones again if you’ve had the condition before, you should avoid dehydration even more than the average person. To make sure you’re producing enough urine, your doctor might ask you to measure your daily urine output. The doctor will also likely instruct you to pay attention to the color of your urine. You should always strive for pale yellow. As soon as you notice it’s getting darker than that, increase your water intake. Home Remedies Although drinking more water may be enough for some cases of kidney stones, adding a couple of healthy herbs certainly won’t hurt. There are various herbs and home remedies that promote kidney health and may help you fight kidney stones. Below are some of the best herbs that can be beneficial to our kidneys and help prevent and treat kidney stones. Most of these are best consumed in the form of a drink such as a juice or tea. Palo Azul BarkTea Also referred to as “Kidney Wood”, Palo Azul bark is a natural diuretic that can help promote kidney health. It helps us excrete sodium and water, which makes it a potentially good option for treating various kidney abnormal conditions. Isoflavones, compounds commonly found in Palo Azul, have been mentioned to have beneficial effects against kidney stones. To reap the benefits of Palo Azul bark, you can take Palo Azul bark tea. Three and four cups of this beverage should be enough to get all the benefits you need. You can learn more about using Palo Azul tea to help kidney stones here. Wheatgrass Juice As mentioned above, increased urine production is one of the best ways to fight kidney stones, and wheatgrass juice is often considered a good home remedy for this condition. It contains several compounds that can increase our urine production and allow the stones to pass more easily. You can drink between two and eight ounces of wheatgrass juice or pure extract daily, or you can swap this out for supplemental pills and powders that may be equally as effective. Celery Juice Another herb that can help increase your urine production, celery is also known for its potent antioxidant qualities. This makes it an even better solution for fighting kidney stones, as it may eliminate many of the oxidants that contribute to kidney stone formation. Celery contains compounds such as caffeic acid, p-coumaric acid, ferulic acid, apigenin, luteolin, tannin, saponin, and kaempferol, and thus has powerful antioxidant characteristics. You can blend a couple of celery stalks with water to make celery juice and consume this drink throughout the day. However, you should avoid this drink if you have: - Low blood pressure; - Any bleeding disorder; - A scheduled surgery as it increases the risk of ob bleeding during surgery. Or if you’re taking: - Lithium (Lithane); - Levothyroxine (Synthroid); - Medications that affect your sun sensitivity, like isotretinoin (for acne treatment) (Sotret).[1] Dandelion Root Juice or Extract Dandelion root juice can stimulate the production of urine and bile. This helps our body get rid of waste and improves digestion. If you choose to take it in the form of a pill, around 500 milligrams of dried dandelion extract could help you prevent kidney stones or ease your symptoms. If you choose to go for dandelion tea or juice, you should stick to between three and four cups per day. Avoid taking dandelion if you’re taking: - Antacids; - Blood thinners; - Antibiotics; - Lithium (Lithane); - Diuretics. Basil Basil is rich in acetic acid, which may help break down kidney stones. It also affects the blood level of uric acid, which can prevent the development of future stones. You can make tea using dried or fresh basil leaves and drink this beverage several times a day. You can also blend fresh basil into a smoothie or juice. You shouldn’t take basil as a medicine for more than six weeks. Using basil for too long can lead to several health problems, including: - Low blood sugar; - Increased bleeding; - Low blood pressure; - You should avoid if you have scheduled surgery. Losing Weight As we mentioned before, obesity is one of the key risk factors for kidney stones, especially for women. In fact, according to research, women who weigh over 220 lbs. are 90% more likely to get kidney stones than women who weigh less than 150 lbs. One reason for this connection could be that higher BMI and increased insulin resistance (both of which are strongly connected to obesity) may increase the amounts of calcium in our urine. That is why losing weight could be one of the best ways to prevent kidney stones. You can do this by engaging in more physical activities and regulating your diet (which we’ll cover in the next section). But, for now, it’s enough to say that we have another reason to stay fit and eat a healthy diet. Dietary Changes Avoiding certain foods and introducing others to your diet can go a long way towards preventing and treating kidney stones. Here are some basic dietary guidelines that can help you fight this condition: - Avoid oxalate-rich foods – the most common type of kidney stones are calcium oxalate stones. If you have a history of developing these stones, your doctor will likely recommend you to avoid oxalate-rich foods as much as you can. These include spinach, okra, beets, rhubarb, chocolate, soy products, nuts, sweet potatoes, and more. - Reduce your intake of animal protein and salt – to avoid getting kidney stones, you may want to go for non-animal protein sources like tofu, lentils, nutritional yeast, green peas, and other protein-rich legumes. You should also use a salt substitute instead of regular salt, as reducing your sodium intake is crucial for preventing kidney stones. But you should remember, that animal proteins are the type of necessary thing for your organism and shouldn't be completely avoided. - Be cautious with calcium, but don’t avoid it – contrary to popular belief, calcium intake from food doesn’t affect your risk of developing kidney stones. So, you can eat calcium-rich foods as you normally would, unless your doctor tells you otherwise. However, you should be cautious with calcium supplements, as they have been connected to an increased risk of kidney stones. In addition, people can lower their risk of kidney stone recurrence only if the the daily amount of calcium is taken from food. Best foods to improve kidney health Here are some of the best foods to help prevent and treat kidney stones. Pomegranates This healthy fruit may help with kidney stones because of its antioxidant properties and ability to affect the concentration of acidic compounds in our urine. Lower acidity levels can greatly reduce your chances of developing kidney stones, while pomegranate’s antioxidant qualities can affect the compounds that contribute to stone formation. You can eat pomegranate seeds whole or juice them to reap the health benefits of this fruit. Lemons The reason why lemons could help with kidney stones is their high contents of citrate – a compound that can prevent calcium deposits from forming. This compound can also make smaller stones easier to pass by breaking them up. You can squeeze lemons into a glass of warm water and drink this mixture every morning, right after waking up. Drinking it one more time just before dinner may also be beneficial. Kidney Bean Broth Kidney beans are rich in magnesium, which has been found to help with calcium absorption. This can be very important for preventing kidney stones and relieving symptoms of kidney stones. You can remove kidney beans from their pods and boil them for between four and five hours. You can then strain this liquid and consume it once cooled. Apple Cider Vinegar The reason why apple cider vinegar could help with kidney stones is its high contents of citric acid. This acid can help us dissolve calcium deposits that are often the cause of kidney stones. You can add two tablespoons of apple cider vinegar to a glass of water and drink this mixture several times a day. It may be best to drink it right before a meal. Alternatively, you can also buy apple cider vinegar supplements if you find it hard to drink this mixture. Medications In addition to lifestyle changes and natural remedies, there are several clinically proven drugs that can help manage kidney stones. These medications can help regulate the amounts of salts and minerals in your urine. Painkillers are commonly prescribed to help with the symptoms, but they won’t affect the size of your kidney stones or their future reoccurrence. Depending on which type of kidney stones you have, your doctor may prescribe you various types of drugs. Here are some of the most common ones. - Calcium stones – for this type of kidney stones, your doctor will likely prescribe a phosphate-containing preparation or a thiazide diuretic. - Uric acid stones – these stones are best treated with allopurinol (Zyloprim, Aloprim). This drug is used to reduce the amount of uric acid in our blood. In addition to this medication, your doctor may also recommend a drug that will make your urine more alkaline. The combination of an alkalizing agent and allopurinol is often enough to prevent further formation of uric acid stones. - Struvite stones – these kidney stones usually form as a response to an infection. To prevent them, your doctor will likely prescribe medication to keep your urinary tract bacteria-free. Small doses of antibiotics for an extended period may help prevent struvite stones. - Cystine stones – people who have these stones have a hereditary disorder that causes their kidneys to produce too much cystine. They can be difficult to treat. Your doctor may instruct you to drink much more fluids to produce a high amount of urine. They may also prescribe you a medication that affects the amount of cystine present in your urine. These drugs will help control the substances in your urine. In addition to these, your doctor may also prescribe medications to treat your symptoms. These include painkillers like acetaminophen (Tylenol) and ibuprofen (Advil, Motrin IB). You should avoid from possible interaction of these substances with other types of drugs. Your doctor may also prescribe you an alpha-blocker – a type of drug that bounds to specific targets in your ureter and relaxes the muscles in it to help you pass the stones more easily and painlessly. Medical Procedures to Remove Kidney Stones If all else fails or you have a severe case of kidney stones, your condition may require surgical intervention or another type of medical procedures. This is usually the case when the stones are too big to pass through the urinary system and they may cause kidney damage and bleeding. The procedures range from minimally invasive surgery to surgical removal of the stones that requires an incision. Here are some of the most common procedures to remove large kidney stones. Sound Waves ESWL (extracorporeal shock wave lithotripsy) is a common procedure that uses high-energy sound waves to break up large kidney stones into small pieces. You can then pass these small fragments through your urinary system like in cases of mild progression of the disease. The procedure takes between 45 and 60 minutes and may cause moderate pain, which is why doctors use light anesthesia or sedation. It should be noted, that very large stones cannot be treated this way. As this procedure is performed under the exposure of X-rays, it is prohibited for pregnant woman. The procedure can cause blood in the urine, bruising on your abdomen or back. When you pass the smaller particles through your urinary tract afterward, you are also likely to experience some pain. Removing Stones with a Ureteroscope Another procedure that doesn’t require an incision involves a thin tube inserted through your urethra. This tube then reaches the ureter through the bladder and the system in it is used to locate the stones. Once they are located, they can be broken up into smaller pieces that you can later urinate out. This procedure requires local or general anesthesia. To reduce swelling and promote healing after the procedure, your doctor may place a small tube in your ureter. Surgery to Remove Large Stones By making a small incision in your back, the doctor can then surgically remove larger kidney stones. Through this incision, the surgeon will then insert small telescopes and additional instruments. You will need general anesthesia for this procedure, and it’s very likely that you’ll be required to spend some recovery time in the hospital (usually around two to three days). This procedure is often recommended when ESWL (Shock Wave Lithotripsy) isn’t successful. Parathyroid Gland Surgery In some cases, calcium phosphate stones can be caused by the overproduction of hormone p by our parathyroid glands. These are located behind the thyroid gland on the neck, just below Adam’s apple. This condition is called hyperparathyroidism and usually starts with a benign tumor. Once this tumor is removed, the formation of this type of stones will be aborted. The Bottom Line If diagnosed in time and treated with caution, kidney stones are unlikely to cause you a lot of problems. Although they may feel uncomfortable (especially when you pass them), they rarely cause any permanent damage. If you notice any symptoms of this condition, schedule an appointment with your doctor. You may only need to drink a lot of fluids and try some home remedies, but it’s best to consult a professional to determine the severity of your condition and the best treatment plan. Footnotes [1] https://www.emedicinehealth.com/celery-page3/vitamins-supplements.htm
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Hipertenzija s urolitijaze Prevencija Što je to? Bubrežni kamenac se stvara iz kristala koji se talože iz mokraće i nakupljaju na unutrašnjim površinama bubrega. Urolitijaza je stručni medicinski izraz kojim se opisuju kamenci koji se pojavljuju u urinarnom traktu. Opis bolesti Normalno, mokraća sadrži kemijske tvari koje sprečavaju ili koče stvaranje kristala. Međutim, čini se da ti inhibitori ne djeluju kod svih ljudi i kod nekih osoba se stvaraju kamenci. Ako kristali ostanu dovoljno sitni, putovat će kroz urinarni trakt i izaći izvan tijela mokraćom, a da to osoba niti ne primijeti. Bubrežni kamenci mogu sadržavati različite kombinacije kemijskih tvari. Najčešća vrsta kamenaca sadrži kalcij u kombinaciji ili s oksalatom ili fosfatom. Te kemijske tvari dio su čovjekove normalne ishrane i sačinjavaju važne dijelove tijela, kao što su kosti i mišići. Rjeđi oblici su kamenaci mokraćne kiseline i cistinski kamenaci. Tko obolijeva? Iako se kamenci češće pojavljuju kod muškaraca, broj žena koje obolijevaju od bubrežnih kamenaca povećava se tijekom zadnjih 10 godina, zbog čega se taj omjer mijenja. Bubrežni kamenci Bubrežni kamenci većinom pogađaju ljude u dobi od 20 do 40 godina. Kad se jedanput kod neke osobe pojavilo više od jednog kamenca, vjerojatnije je da će ih se pojaviti još. Kod osobe u čijoj su obitelji postojali slučajevi bubrežnih kamenaca postoji veća vjerojatnost da će ih dobiti i ona. Infekcije urinarnog trakta, bubrežni poremećaji kao što su cistične bubrežne bolesti i metabolički poremećaji kao što je hipertiroidizam također su povezani sa stvaranjem kamenaca. Pored toga, bubrežni kamenci se razvijaju kod više od 70 posto bolesnika s nasljednom bolesti nazvanom renalna tubularna acidoza. Cistinurija i hiperoksalurija druga su dva rijetka nasljedna poremećaja koja često uzrokuju bubrežne kamence. Drugi uzroci bubrežnih kamenaca su hiperurikozurija poremećaj metabolizma mokraćne kiselineulozi, prevelik unos vitamina D i začepljenje urinarnog trakta. Neki diuretici pilule za istjerivanje vode iz tijela ili antacidi na osnovi kalcija mogu povećati rizik od stvaranja kamenaca jer povećavaju količinu kalcija u mokraći. Simptomi Obično je prvi simptom bubrežnog kamenca izuzetno jaka bol. Bol obično započinje naglo kad se kamenac počne pomicati u urinarnom traktu, izazivajući iritaciju ili začepljenje. Obično čovjek osjeća oštru, grčevitu bol u leđima i boku u području bubrega ili donjeg dijela trbuha. Ponekad se uz ovu bol pojavljuje mučnina i povraćanje. Kasnije se bol može širiti u prepone. Ako je hipertenzija s urolitijaze prevelik da bi lako prošao, bol se nastavlja kako mišići u uskoj mokraćnoj cijevi nastoje istisnuti kamenac prema dolje u mokraćni mjehur. Kako kamenac raste ili se pomiče, može se pojaviti krv u mokraći. Kako se kamenac spušta niz mokraćnu cijev bliže mjehuru, osoba može osjećati češću potrebu za mokrenjem ili osjećati pečenje prilikom mokrenja. Ako ove simptome prati povišena temperatura ili groznica, može biti prisutna infekcija. Dakle, u ovom članku, glavni uzroci i znakovi zbog kojih nastaje cista parenhima desnog bubrega. Također, pozornost je posvećena glavnim metodama dijagnoze i liječenja ove bolesti. U tom slučaju, treba se odmah obratiti liječniku. Koja se ispitivanja mogu napraviti? Ponekad se "tihi" kamenci koji ne uzrokuju simptome nađu na rendgenskoj snimci napravljenoj tijekom općeg zdravstvenog pregleda. Ti bi kamenci vjerojatno prošli neprimijećeni. Češće, bubrežni kamenci se nađu na rendgenskoj ili ultrazvučnoj snimci osobe koja se žali na krv u mokraći ili iznenadnu bol. Koliko je opasna cista parenhima desnog bubrega? Te dijagnostičke slike daju liječniku korisne informacije o veličini i smještaju kamenca. Ispitivanja krvi i mokraće pomažu kod otkrivanja mogućih nenormalnih supstanci koje mogu pospješivati stvaranje kamenaca. Liječnik može odlučiti snimiti urinarni trakt specijalnim rendgenskim ispitivanjem nazvanim intravenska urografija. Zajedno, rezultati ovih ispitivanja pomažu kod određivanja odgovarajućeg liječenja. Liječenje Srećom, većina kamenaca može se liječiti bez operacije. Većina bubrežnih kamenaca može proći kroz urinarni sustav uz mnogo vode hipertenzija s urolitijaze do 3 litre dnevno koja pomaže kamencu da se spusti. U većini slučajeva, osoba može ostati kod kuće tijekom tog procesa, uzimajući lijekove protiv bolova prema potrebi. Liječnik može prepisati određene lijekove kako bi se spriječilo stvaranje kalcijevih kamenaca i kamenaca mokraćne kiseline. Opstruktivna uropatija Ti lijekovi kontroliraju količinu kiseline ili lužine u mokraći, što je ključni faktor kod stvaranja kamenaca. Lijek alupurinol također može biti koristan u nekim slučajevima hiperkalciurije i hiperurikozurije. Još jedan način na koji liječnik može pokušati kontrolirati hiperkalciuriju, a time i spriječiti stvaranje kalcijevih kamenaca, je prepisivanje diuretika, kao što je hidroklorotijazid. Ti lijekovi smanjuju količinu kalcija kojeg bubrezi ispuštaju u mokraću. Neki oblik kirurške operacije može biti potreban radi uklanjanja bubrežnog kamenca ako kamenac: - ne iziđe nakon razumnog hipertenzija s urolitijaze razdoblja i izaziva stalne bolove - prevelik je da bi izišao sam - priječi protok mokraće - izaziva stalnu infekciju urinarnog trakta - oštećuje bubrežno tkivo ili izaziva stalno krvarenje - povećava se Ekstrakorporealna litotripsija šok valovima popularno "razbijanje kamenaca" najčešće je korišteni postupak za liječenje bubrežnih kamenaca. Policistična bolest bubrega Koriste hipertenzija s urolitijaze šok valovi koji se stvaraju izvan tijela i putuju kroz kožu i tjelesna tkiva sve dok ne udare u guste kamence. Kamenci se pretvaraju u pijesak i lako prolaze kroz urinarni trakt mokraćom. Vrijeme oporavka je kratko, i većina se ljudi može vratiti normalnim aktivnostima nakon nekoliko dana. Ponekad se za uklanjanje kamenca preporučuje postupak nazvan perkutana nefrolitotomija. Ovaj postupak se često koristi kad je kamenac prilično velik ili na mjestu koje ne dozvoljava djelotvornu upotrebu šok valova. Prevencija Da bi se spriječilo stvaranje kamenaca, mora se utvrditi njihov uzrok. Urolog će odrediti laboratorijska ispitivanja, uključujući ispitivanja krvi i mokraće. On će također ispitati bolesnika o anamnezi, poslu koji obavlja i prehrambenim navikama. Jednostavna i najvažnija promjena u načinu života radi sprečavanja stvaranja kamenaca je piti više tekućine, najbolje vode. Bolesnici koji imaju previše kalcija ili oksalata u mokraći možda će morati jesti manje hrane koja sadrži kalcij i oksalate. Dijagnoza Na opstruktivnu uropatiju treba misliti u svih bolesnika sa smanjenom ili odsutnom diurezom ili neobjašnjenom insuficijencijom bubrega. Anamneza zna ukazati na simptome urolitijaze, BPH ili maligniteta. Većina se opstrukcija može ispraviti pa rana dijagnoza i liječenje sprečavaju ireverzibilno oštećenje bubrega. Vrši se analiza mokraće i krvi serumski elektroliti, urea, kreatinin. Druge se pretrage provode prema kliničkoj slici i očekivanoj razini začepljenja. Međutim, neće svi imati koristi od prehrane s malo kalcija. Neki bolesnici koji imaju visok nivo oksalata u mokraći mogu imati koristi od dodatnog kalcija u prehrani. Bolesnicima će se možda reći da izbjegavaju hranu u koju je dodan vitamin D i određene vrste antacida na osnovi kalcija. Bolesnici koji imaju vrlo kiselu mokraću možda će morati jesti manje mesa, ribe i peradi. Da bi se spriječilo nastajanje cistinskih kamenaca, bolesnici trebaju svaki dan piti dovoljno vode kako bi smanjili količinu cistina koji ulazi u mokraću. Soon We'll Cure Diseases With a Cell, Not a Pill - Siddhartha Mukherjee - TED Talks Osobe sklone stvaranju kamenaca kalcijevog oksalata liječnik će možda zamoliti da smanje unos određene hrane sa sljedećeg popisa. Bolesnici ne trebaju prestati jesti hipertenzije i propranolol izbjegavati ovu vrstu hrane bez prethodnog dogovora s liječnikom. Cistična bolest bubrega u sindromima malformacije Policistična bolest bubrega Policistična nefropatija je nasljedno stvaranje bubrežnih cista koje dovodi do postupnog uvećanja oba bubrega i ponekad progredira do uremije. Gotovo svi oblici su posljedica obiteljske genetske mutacije. Javljaju se bolovi u slabinama i u trbuhu, hematurija i hipertenzija. Dijagnoza se postavlja CT ili UZ pretragom. Liječenje je do uremije simptomatsko, a nakon toga nadomjesno.