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(Adnkronos Salute) - "Una fitta lancinante a un fianco. Pronto soccorso, Tac, ecografia, analisi del sangue" e la diagnosi: "Probabile calcolo renale". Gianmarco 'Gimbo' Tamberi ha descritto così, ieri sera via Instagram, l'imprevisto che lo ha costretto a rimandare la partenza per le Olimpiadi di Parigi 2024. "Un violento dolore al fianco" è il campanello d'allarme che annuncia la colica renale, "il sintomo più tipico" della calcolosi, un problema comune che può colpire fino a una persona su 10. Ma cos'è un calcolo renale? Da cosa dipende? E come si cura? Lo spiegano gli esperti dell'ospedale Niguarda di Milano, in un approfondimento pubblicato sul sito dell'Asst Grande Ospedale Metropolitano. "Il calcolo renale (o nefrolitiasi)", descrivono, si crea "quando nelle urine la concentrazione dei sali litogeni (calcio, acido urico, ossalato), aumentando, forma i primi cristalli che poi, aggregandosi tra di loro, costituiscono il calcolo vero e proprio. Si tratta di un problema che interessa dal 5 al 10% della popolazione, con un trend di crescita negli ultimi decenni, imputabile al maggior consumo di proteine animali nella nostra alimentazione". Per evitare i calcoli renali bisogna "mantenere le urine in condizione di sottosaturazione, cioè ben diluite, garantendo una costante e frazionata idratazione per produrre diuresi superiore a 2 litri". Quando si formano, comunque, "i calcoli non sono tutti uguali. Ne esistono di diversi tipi: ci sono quelli più comuni formati dai sali di calcio, ci sono quelli di acido urico e quelli di struvite, conseguenti ad una particolare infezione urinaria. Poi possono esserci quelli di cistina, causati da una rara patologia ereditaria", precisano da Niguarda. "Per la diagnosi del tipo di calcolosi è essenziale analizzare la composizione del calcolo una volta espulso, mediante un esame chimico o cristallografico".Ma come si manifesta un calcolo ai reni? "Il sintomo più tipico", appunto, "è la colica renale, cioè un violento dolore al fianco accompagnato da vomito e irrequietezza, dovuto allo spostamento del calcolo lungo le vie urinarie. A volte può essere solo presente una lombalgia sorda, tipo un mal di schiena. Un'altra possibilità è l'evenienza di una macro o microematuria anche senza sintomi, cioè la presenza di sangue nelle urine. In caso di colica renale in corso", si raccomanda di "non sottovalutare il fenomeno che potrebbe ripresentarsi nel tempo. Inoltre è consigliato effettuare delle analisi del sangue e delle urine per identificare i cosiddetti fattori di rischio metabolici. E' poi importante eseguire dei controlli radiologici, come un'ecografia delle vie urinarie e/o una Tac all'addome senza contrasto".La terapia? I calcoli renali vanno sempre rimossi o possono andarsene da soli? "Un calcolo intorno ai 6 millimetri ha elevate possibilità di espulsione spontanea - rispondono gli specialisti di Niguarda - mentre la percentuale si riduce con l'aumentare delle dimensioni. Quando raggiungono dimensioni maggiori, è necessario l'intervento terapeutico. Fino a qualche anno fa l'unica speranza era quella chirurgica, che attraverso tecniche diverse risolveva la situazione mediante asportazione o frammentazione dei calcoli. Adesso invece si è diffusa la litotrissia, che permette di curare senza tagli. Il litotritore è una macchina in grado di produrre delle onde d'urto che vengono inviate con precisione, con l'aiuto dei raggi X o dell'ecografia, in modo da essere concentrate sui calcoli stessi. Queste onde attraversano i tessuti molli dell'organismo e scaricano la loro energia sui calcoli così da frammentarli. L'ecografia è in grado di evidenziare numero e dimensione dei calcoli, sede ed eventuale presenza di dilatazione delle vie escretrici". Anche l'alimentazione può aiutare. "La terapia comune per tutte le calcolosi prevede la diluizione urinaria: bere molti liquidi, molta acqua, va bene anche quella del rubinetto - chiariscono gli esperti - Ci sono studi che lo confermano: avere un'idratazione giornaliera pari o superiore ai 2 litri limita le recidive, che sono frequenti per questo tipo di patologia". Un altro consiglio è "ridurre sensibilmente il consumo di sale e di proteine animali, come carne, pesce e uova". "Contrariamente a quello che si pensava fino a qualche anno fa - puntualizzano infine da Niguarda - la dieta deve essere normo-calcica. Cioè non bisogna bandire alimenti come latte, formaggi e yogurt". Fra l'altro, a volte, "questo poteva creare dei grossi problemi a livello scheletrico, soprattutto se il paziente aveva dei livelli alti di dispersione di calcio nelle urine. In alcuni casi, infatti, calcoli e osteoporosi possono correlarsi". di Adnkronos   05-08-2024 - 14:25 Link copiato Commenti Leggi la Netiquette

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