En af de mest almindelige sygdomme i urinvejene er nyresten (renal calculi). Det er faste stykker af materiale, der dannes i nyrerne fra stoffer i urinen. De kan være så små, at de er usynlige for det blotte øje, eller så store som en perle.
Af Anett Kromann
Artiklen blev bragt i magasinet sund-forskning – april/maj 2019 og er en del af en artikelsamling om stofskiftet
Små nyresten behøver ikke at udløse nogen symptomer overhovedet, men større sten kan give anledning til en skarp smerte, kramper, smerter i ryggen og i siden i det område, hvor nyrerne sidder, eller i underlivet, når de flytter sig til urinvejene og blokerer for strømmen af urin. Andre symptomer omfatter ulidelig smerte (normalt i nederste del af ryggen, siden og lysken), vandladningsbesvær, blod i urinen, kulderystelser, kvalme og undertiden feber.
Hvis bakterier bliver fanget i urinen, kan urinvejsinfektion forekomme. Hvis disse sten blokerer urinvejene i lang tid, kan nyrerne udspiles (hydronefrose) og til sidst ødelægges.
Årsagerne til nyresten er undersøgt
Omkring 75 % af de sten, der dannes i urinvejene, er sammensat af calcium. Høje niveauer af calcium i urinen kan bidrage til stendannelse, og citrat kan hjælpe med at forhindre stendannelse ved binding til calcium, før det krystalliserer.
Det er overraskende, at jo flere calciumholdige fødevarer, du spiser, jo lavere er din risiko for nyresten. Dette blev bekræftet af en undersøgelse, der involverer 91.731 sygeplejersker i alderen 34 og 59, hvoraf ingen nogensinde havde haft nyresten. I løbet af de 12 år, undersøgelsen varede, havde 864 af sygeplejerskerne udviklet nyresten (i gennemsnit omkring en ud af hver 1.000 deltagende). Forskerne fandt, at jo højere indtag af calcium i kosten, jo mindre chance havde sygeplejerskerne for at udvikle sten. Hvis calciumindtaget var højt blandt sygeplejerskerne, og de samtidig indtog kalktilskud, var risikoen for at udvikle nyresten 20 procent højere end normalt. Kost med meget højt proteinindhold eller C-vitamin, og ikke tilstrækkeligt indtag af vand, kan øge risikoen for stendannelse. Desuden kan urinvejsinfektioner, nyrelidelser såsom cystiske nyresygdomme og visse metaboliske lidelser, såsom hyperparathyroidisme (sygdom i biskjoldbruskkirtlerne, som sidder på bagsiden af skjoldbruskkirtlen) også øge risikoen for at danne sten.
Galdesten
I årtier har en velkendt risikofaktor for udvikling af galdesten været hypothyreose. Nylige undersøgelser har vist, at risikoen navnlig er stigninger af galdeproblemer ved klinisk og subklinisk hypothyreose (truende lavt stofskifte). Der er flere faktorer, der kan bidrage til dannelsen og/eller akkumulering af galdesten hos hypothyreose-patienter, herunder nedsat lever/kolesterol metabolisme og nedsat galdesekretion.
Problemer med galdeblæren kan føre til en tyk og træg galdeblære på grund af den manglende evne til at emulgere (udtømme) fedtstoffer. Ufordøjet fedt og olie vil forstyrre optagelsen af andre næringsstoffer. Funktionssvigt i galdeblæren vil gøre det vanskeligere at fordøje fødevarer og kosttilskud.
Nogle mennesker ved allerede, at de har et galdeblæreproblem. Nogle af de mest almindelige symptomer på galdeblæreproblemer omfatter oppustethed, gas og mavesmerter; disse symptomer vil typisk opstå lige efter spisning.
På den anden side, er mange mennesker ikke klar over, at de har et galdestensproblem. Mens nogle mennesker har tydelige symptomer, føler de måske, at disse symptomer er “normale”. De fleste menneskers fordøjelse er så skruet op, at vi fejlagtigt antager, at det at have konstant gas, kvalme og/eller fordøjelsesbesvær er normen. Nogle gange vil de endda afvise enhver smerte, de oplever, hvad enten det er mavesmerter eller smerter mellem skulderbladene, som begge er mulige symptomer for galdesten.
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