Kidney Stones Flashcards
Why do renal stones occur?
Due to an imbalance between solutes and solution leading to a precipitation of the solutes out of solution
What is the other name for kidney stones?
Nephrolithiasis
Women are more commonly affected by kidney stones than men. T/F?
False - men are more commonly affected
What is the composition of the majority of kidney stones?
Calcium
What is the name for kidney stones which contain magnesium, ammonium and phosphate?
Struvite stones
1-2% of kidney stones are composed of…?
Cysteine
How common are uric acid kidney stones?
5-10% of all kidney stones
How common are struvite kidney stones?
5-10% of all kidney stones
What are the risk factors for nephrolithiasis?
BMI of over 27 Sedentary lifestyle History of UTI Caucasian race Dehydration positive family history of nephrolithiasis
What type of diets have a protective role in the development of nephrolithiasis?
High fibre, high fruit diets
What type of pain results from kidney stones?
Colicky pain from loin to groin
What are the associated factors of pain from kidney stones?
Nausea
Vomiting
What might be the findings of a renal examination of kidney stones?
Flank tenderness Signs of infection Obesity Hypertension Diabetes mellitus Gouty tophi
What conditions may cause nephrolithiasis?
Primary hyperparathyroidism Hypercalcaemia Hyperoxaluria Hyperuricaemia Cystinuria Hypocitraturia Renal tubular acidosis
What type of kidney stones tend to develop at a pH of >7.0?
Calcium and struvite stones
What type of stones tend to develop at a pH of <6.0?
Cysteine stones
How would a kidney stone smaller than 2cm be managed?
Expectant management
extracorporeal shock wave lithotripsy
How is a kidney stone, larger than 2cm managed?
Expectant management
Percutaneous ultrasound lithotripsy
How much time should be allowed for small ureteral stone (<7mm) to pass by themselves?
2-4 weeks
How can large ureteral stones be removed?
Uteroscopic stone fragmentation
Open surgery
What is the advantage of using ureteral stents in the management of kidney stones?
These drain the obstructed kidney to alleviate pain
Dilate the ureter to facilitate passage of the stone
Facilitate the performance of uteroscopic procedures
Preventative treatments, to prevent further stone formation can be given. What preventative treatments are given in the case of calcium phosphate stones?
Citrate
Thiazide if hypercalciruic
Preventative treatments, to prevent further stone formation can be given. What preventative treatments are given in the case of calcium oxalate stones?
Citrate
Thiazide if hypercalciruric
Low oxalate diet
Preventative treatments, to prevent further stone formation can be given. What preventative treatments are given in the case of uric acid stones?
Xanthine oxidase inhibitors (allopurinol / rasburicase)
alkalinised urine to >6.0
Preventative treatments, to prevent further stone formation can be given. What preventative treatments are given in the case of cysteine stones?
Alkalinising urine to >7.0
Reduce protein and sodium in the diet
Which type of kidney stone is commonly caused by infection?
Struvite stones
How does citrate reduce urinary supersaturation of calcium?
By binding to calcium and forming soluble complexes which inhibit the growth of calcium crystals
How can citrate inhibit the formation of irate and cysteine stones?
By having an alkalinising effect
