Kidney stones Flashcards
What is the most common type of kidney stone?
Calcium oxolate
What colour of ‘calcium oxolate’ stone?
Dark brown/ black stone
Factors which increase likelihood of ‘ caclium oxolate’ stone development?
- Acidic urine
- Diet heavy in oxolate - rhubarb. spinach, chocolate
- Defect in liver metabolism
What is the colour of ‘calcium phosphate’ stone?
Dirty white
Factors which increase likelihood of ‘calcium phosphate’ stone developing?
- Alkaline urine ( caused by renal tubular acidosis 1 and 3 )
- Hypercalciuria
What is the colour of ‘Uric acid’ stone?
Red brown in colour
Factors which increase the likelihood of ‘Uric acid stone’ developing?
- Consuming lots of purine
- Shellfish
- Anchovies
- Red meat - Low pH
- More common in children with inborn errors of metabolism
When do Struvite stone / Staghorn form?
Form when infection from bacteria results in enzyme urease being used to break down urea to ammonia and carbon dioxide
What is the colour of ‘Struvite stone’?
Dirty white
Factors that increase the likelihood of ‘Struvite stones’ forming?
Alkaline urine
- Urinary tract infections
- Vesicoureteral reflux
Clinical features of renal stones
- loin to groin pain: typically severe, intermittent ‘colic’ pain. The patient often is restless/moving around
- nausea and vomiting is common
- haematuria
- dysuria
- secondary infection may cause fever
Ix for urinary stones
- urinalysis
- blood tests
- plain x ray - shows stones
- IV urogram and ultrasound of the kidneys
Acute management of renal stones
(indic if obstruction is present/urological emergency)
- analgesia
- percutaneous nephrostomy
What surgical interventions can be done?
- Extracorporeal shockwave lithotripsy
- Ureteroscopy - flexible ureteroscope passed via the urethra
- Percutaneous nepthrolithotomy - sutaible for large stones or staghorn calculus
Diagnostic Ix of choice
non contrast CT KUB (kidney ureters and bladder)
