nephrolithiasis Flashcards
What factors determine how destructive an obstruction is?
Degree
Location
Duration
Timing
levels obstruction
renal pelvis - where urine collects
ureter - severe pain with movement
bladder and urethra
obstruction complications and back up pressure
hydroureter
hydronephrosis
postrenal acute kidney injury
manifestations of acute obstruction
Depend on the: Site Cause (ex., kidney stones, prostate problems) Speed of onset - acute = increased pain - chronic = decreased pain
Which factor primarily determines severity of pain?
- degree of blockage in space
Nephrolithiasis
Renal calculi or Kidney Stones
Definition: clumps of crystals in the urinary tract
where do kidney stones form?
renal pelvis
where are kidney stones located?
anywhere from renal pevis to bladder
Nephrolithiasis: Risk Factors
Sex: Men (for now)
Age: 20s – 30s
Race: white
Family history
Congenital defect - kidney or urinary system
Weather? - hot and increased risk dehydration
Obesity
Nephrolithiasis: Etiology
Etiology = crystallized solutes in the urine
Etiology depends on:
Individual risk factors
Characteristics of the urine (diet, medications)
Type of stone being formed
types of stones
calcium oxalate
struvite “staghorn”
uric acid
Nephrolithiasis: Pathogenesis
Urine is a solution of solvent (water) and solutes (particles)
Problem: Super-saturation with a solute
Crystals begin forming in the nephron
Crystal formation is enhanced by:
Dehydration
Immobility/sedentary lifestyle
clinical manifestations
Acute renal colic - sharp, intermittent Location - flank CVA Radiation - along groin Spasms - wave, sharp, severe Intermittent Sharp
Accompanying symptoms: N/V decreased respiratory depth Diaphoresis ↑HR, ↑RR Manifestations of lower UTI (dysuria, hematuria, etc)
stones pharm
Acute Pain: Morphine or NSAIDS IV fluids Preventive meds: Calcium = thiazide diuretics Struvite = antibiotics Urate = allopurinol (covered in gout lecture)
