Most people with cystinuria experience recurrent episodes of kidney stones that typically amount to more than once each year. This can lead to a number of effects that have a noticeable impact on the affected individual's quality of life.
While the overall prognosis of cystinuria is positive, there are several complications of the condition that can have severe repercussions. It is important that patients have an understanding of these possible complications and their early warning signs to enable them to seek timely medical management.
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Renal colic is a condition that causes moderate to severe pain as a result of the movement of a kidney stone down the ureter towards the bladder.
This pain is usually reported in the lower back and is commonly concentrated to one side as the stone is moving down a ureter on one side. Although the pain typically begins in the lower back, often progresses down towards the groin as the stone moves.
Individuals affected by cystinuria are more likely to suffer from infections of the urinary tract as compared to other members of the general population. Some of the common symptoms of a urinary tract infection (UTI) include:
- Frequent urge to pass urine
- Pain or burning on urination
- Cloudy urine with a pungent smell
- Back pain
In severe cases, the UTI can spread beyond the bladder and into the kidneys, thus causing more severe symptoms such as fever, nausea, and vomiting to arise.
Hydronephrosis involves a blockage of the ureter, usually as a result of a stone lodged in the area, and causes the urine to flow back up into the kidney. This affects the function of the kidney, as the organ becomes enlarged and the area is also prone to infection.
Signs of hydronephrosis may include:
- Abdominal pain
- Increased frequency of urination
- Pain on urination
- Nausea and vomiting
While the kidneys can often regain their previous function with the removal of the stone that has been blocking the ureter, kidney function, in rare cases, can be irreversibly damaged.
Damage to the urinary tract can lead to recurrent infections and blockages in the area that may require reparative surgery, which can also cause scar tissue to develop. Over time, this can lead to renal insufficiency or renal disease.
What is Cystinuria?
Management of complications
It is essential that the complications of cystinuria are adequately managed as soon as possible to prevent further damage to the renal system.
This process involves early detection with regular tests to monitor the function of the kidneys and detect any damage. A physical examination can be used to check for enlargement of organs in addition to a laboratory urine examination, which is helpful in testing the concentration of substances in the urine.
In some cases, diagnostic imaging may be used to gain insight into the extent of swelling and the area of the renal system that is likely to be affected by the blockage. An ultrasound or computed tomography (CT) scan may be useful for this purpose.
A catheter can help to drain some of the fluid from the renal tract and remove any obstruction that may be causing symptoms. Depending on the specific nature of the complication, the management plan might also require treatment with antibiotics, the insertion of a urinary stent, and/or nephrostomy tube.