18 Kidney Stones (Urolithiasis)

Question 1

What are kidney stones (urinary calculi) usually made up of?

Answer 1

Calcium

Question 2

What % of people in the UK with have a kidney stone at some point in their life?

Answer 2

2-3%

Question 3

What is required (in terms of the composition of urine) for stone formation?

Answer 3

Supersaturation of mineral making up stone in urine

Question 4

Where can stones be located?

Answer 4

• Kidney
  
  • Staghorn
  • Non-staghorn
• Ureteral
  
  • Proximal
  • Middle
  • Distal
• Bladder

Question 5

90% of stones can be passed out of the urinary tract. For each of the following sizes of kidney stones, give the probabilty of it being passed:

• <5mm
• 5-7mm
• >7mm

Answer 5

• <5mm- high chnace
• 5-7mm- 50% chance
• >7mm- require urological intervention

Question 6

What symptom is associated with the passage of a stone down the urinary tract?

Answer 6

Renal colic (flank pain)

Question 7

Approximately 10% of kidney stones can’t be passed in urine. How can they be removed?

Answer 7

• Ureteroscopy
• Percutaneous nephrolithotomy
• Shock wave lithotripsy (non-invasive)

Question 8

Give some examples of congenital/genetic abnormalities that increase someones risk of developing UTIs?

Answer 8

• Duplex ureters
• Pelvic kidney
• Polycystic kidneys

Question 9

Give some infections that can cause immune mediated glomerulonephritis:

Answer 9

Post-streptococcal glomerulonephritis

Endocarditis-associated glomerulonephritis

Hepatitis B

Hepatitis C

HIV

Question 10

How likely is someone with a kidney stone to get one again?

Answer 10

Recurrence rate= 60-80%

Question 11

What are some causes of kidney stones?

Answer 11

Question 12

What scans can be done to diagnose kidney stones (and see their size and location), if a patient presents with loin to groin pain and haematuria?

Answer 12

1. CT scan
2. Ultrasound
3. X-ray