Kidney stones & Hydronephrosis Flashcards
What is the aetiology of kidney stones?
When the level of insoluble salts or uric acid in the urine is high, or the urine lacks citrate (a chemical that normally inhibits the stone formation), or insufficient water is present in the kidneys to dissolve waste products, kidney stones form.
Most stones form within the kidney, but they can from anywhere within the system.
What are kidney stones?
-(renal calculi)
-Hard insoluble crystallised minerals and salts that have formed from filtrate.
-High concentration of salts and minerals from these crystals.
Where do most kidney stones originate?
Collecting tubules or the renal papillae, then they pass into the real pelvis where they may increase in size.
Can also pass to the bladder.
What are calcium kidney stones?
Are calcium compounds that chemically bind to oxalate or phosphate. Account for approx 60-80% of all urinary stones.
What are uric acid kidney stones?
Account for 5-10% of all stones, they are more common in men.
What are struvite stones?
Are more common in women and their formation is linked to chronic bacterial UTIs and frequent catheters. Account for 10-15% of all stones.
What are cystine stones?
Are the least common and form due to rare inherited condition where there are large amounts of cystine (an amino acid)
What is the prevalence and epidemiology of kidney stones?
One in 11 people get stone symptoms during their life times. Men are affected slightly more than woman, especially caucasians.
Can affect all ages, but the peak age for the first stone is around 45.
What are the risk factors of kidney stones?
Both intrinsic and extrinsic factors.
A diet high in animal protein that contains lots of sugar and salt.
Poor fluid intake.
If the patient has already had a stone there is a 50% chance that they will form another one in the next 10 years.
List some risk factors of kidney stones?
Age and gender
Ethnicity
Diet
Chronic dehydration
Obesity
Medications
Family history
Gastro conditions
Conditions affecting urinary volume
What is the pathophysiology of kidney stones?
- Once any solid or debris forms, deposits continue to build
up on this focus, and then form a large mass. - Cell debris from infections can also cause a focal point.
- Immobility may cause changes in the urine due to stasis in
its flow, leading to stone formation - Stones usually cause symptoms only when they obstruct
the flow of urine - They can cause infection as they lead to stasis of the urine
which in turn causes tissue irritation.
What are the clinical features of kidney stones?
-Frequently asymptomatic
-Stones that obstruct the ureter produce acute sever pain that originates in the flank area and radiates to lower abdomen
-Colic produces severe cyclic pain that occurs when the ureter contracts forcefully trying to push the stone to the bladder.
What are the treatments for kidney stones?
Analgesia
Fluid replacement
Anti emetics
Hospital admission
Surgery
What is hydronephrosis?
A condition where the kidneys become swollen as a result of an obstruction.
Obstruction of urine leads to increased size of renal pelvis.
Causing reflux damage to the kidney and can result in permanent loss of function.
What are the causes of hydronephrosis?
Kidney stones
Congenital blockages
Blood clots
Scarring of tissue
Tumors/some cancers
Enlarged prostate
Pregnancy
UTI’s
