Nephrolithiasis Flashcards
What are the top causes of kidney stones?
Dehydration
Diet
Medications
How much water should patients be drinking?
2-3 L daily
What diet should be encouraged?
Low sodium diet under 2g
If there is a history of kidney stones what study would be beneficial?
24 hour urine study
What are the most common type of stone?
Calcium oxalate
What type of foods should be avoided?
Turkey
Pork
Seafood
Dairy
Nuts
Limit sodas and juices
For a 24 hour urine, what is the procedure?
Start on Sunday
Empty bladder when you first wake up, don’t count this in collection
Write the start time and date
Collect 2nd urine until the next day with ending time being the start time
24 hour urine evaluates:
Urinary stone disease what stones are made of
Proteinuria
Renal function via Cr clearance
If 24 hour urine calcium is higher than 10, check ___, what are you trying to rule out?
PTH; hyperparathyroidism
What is hyperparathyroidism?
Excess of the hormone made by four small glands in the parathyroid gland; symptoms include feeling week or tired, general aches, stomach pain, frequent heartburn
Potassium citrate can potentially cause
hyperkalemia, need to check BMP
Indapamide is contraindicated in
renal insufficiency or hepatic dysfunction
Repeat 24 hour urine collection after adding medications to see if there is improvement in collection, repeat in
4-6 weeks
What is Litholapaxy?
Crushing or disintegration of bladder stones
For stones that are primarily calcium oxalate, what medication do you start patients on?
May need thiazide (Indapamide) 2.5 mg plus potassium citrate 10 mg if urine is acidic
