Kidney Stones Flashcards
medullary sponge kidney
interstitial crystallization
nephrocalcinosis
stone forming diseases and drug related disorders >
neprholithiasis / urolithiasis
in neprhocalcinosis, crystal components found in
body of kidney (vs renal pelvis)
majority of kidney stones made up of
calcium oxilate
struvite cyrstals
mg amonium phosphate - dependent on bacteria in urine raising pH
drugs with high stone causing rate
indinavir
acyclovir
triamterene
sulfamethoxazole
genetic stone causing disease stone make-up
cystinuria
l-cystine
genetic stone causing disease stone make-up
primary hyperoxalosis
calcium oxalate
genetic stone causing disease stone make-up
dent disease
calcium oxalate or calcium phosphate
genetic stone causing disease stone make-up
familal hypomagnesemia with hyper calcimia and neprhocalcinosis
calcium, phosphate
genetic stone causing disease stone make-up
adenosine phosphosribosyltranferase deficiency
2-8 dihydroxyyadenine
genetic stone causing disease stone make-up
distal renal tubular acidosis
calcium phosphate
mutations in L-cystine stone disease
type A - SLC3A1 recessive, proximal tubule S3
type B SLC7A9 - incompletely dominant, transporter proximal tubule
rare recessive disorders of liver enzymes leading to excessive endogenous oxalate synthesis
primary hyperoxalosis / hyperoxaluira
stone risk factors (non-diet)
previous renal disease
IBD/ short gut
hyperparathyoidism
hypercalcemia of CA, sarcoid
Gout
HIV
diet risk factors
low fluid
high salt
high protein
low calcium
high oxalate (spinach, beet, rhubarb, nuts, beans, chocolate, soy)
chronic treatments, cysteine stones
dilution
alkalinize urine
cystine binding drugs (disulfide exchange)
(penicillamine, thipronin, captopril)
chronic treatment uric acid
dilution
low protein high fruit diet
alkanize urine
xanthin oxidase inhibitors (Allopurinol, Febuxostat)
chronic treatment struvite
dilution
sterilize urine (eliminate urea splitting bacteria)
remove residual stone material (surgical)
Urease inhibitors (acetohydroxamic acid)
chemolysis (hemiacidrin)
chronic treatment calcium stones
dilution
maintian normal Ca intake
reduce urine calcium
Reduce urine oxalate
increase urine citrate
in chronic calcium stones, reduce urine calcium via
limit Na and protein in diet
thiazide diuretic
in chronic calcium stones, reduce urine oxalate by
adding calcium or limiting oxalate in diet
add pyridoxine
in chronic calcium stones,increase urine citrate via
reduced protein, increased fruit
add citrate or bicarb supplements
