Kidney Stones

Question 1

What is a kidney stone?

Answer 1

A crystal aggregate formed in the kidney or urinary tract.

Question 2

Name types of kidney stone and how common they are?

Answer 2

Calcium oxalate (60%)
Calcium Phosphate (15%)
Struvite - Magnesium Ammonium Phosphate (5%)
Uric acid (5%)
Mixed

Question 3

When would a struvite stone be most likely to form?

Answer 3

In repeated UTI with bacteria with urease activity.

Question 4

Describe the pathophysiology of Kidney stones?

Answer 4

• Caused by hypocituria. Citrate normally acts as a chelating agent and forms soluable complexes with calcium ions to inhibit crystal growth and aggregation.
• Caused by supersaturation of urine with solutes.

Question 5

Describe clinical features of kidney stones?

Answer 5

• Recurrent UTI’s
• Haematuria
• Dull ache in loins/groin/classic renal colic
• Strangury (urge to pass something that wont pass)

Question 6

Investigations for kidney stones?

Answer 6

hirtor
Imagine
Serology
Urinalysis

Question 7

Risk factors for kidney stones?

Answer 7

genetics 
high urine calcium levels 
overweight, immobile 
dehydration 
calcium supplements 
hyperparathyroidism 
males

Question 8

How are kidney stones treated?

Answer 8

Citrate tablets

Lithotripsy: Using ultrasound to break stone up and then pass naturally.

Percutaneous Nephrolithotomy: Needle guided with fluroscopy to insert a guide. A nephroscope can then be used to go remove the stone.