Nephrolithiasis Flashcards
kidney stones are most common in what demographic?
older white men
what type of stone is caused by UTIs?
struvite
what are the 6 factors that cause kidney stones?
- decreased urine volume, increased urinary concentration
- excessive excretion of stone forming substances
- anatomic abnormalities
- urine pH - alkaline or acid
- presence or absence of urinary inhibitors (citrate, Mg, pyrophosphate, trace metals)
- urinary potentiators (crystal nidus)
what is the main type of kidney stone?
calcium oxalate
what is the appearance of struvite (magnesium ammonium phosphate) crystals?
coffin lid
what are the radiolucent stones?
- uric acid
- cysteine
what is the best diagnostic test to use for kidney stones?
helical CT
what type of environment is conducive for calcium stones?
- volume
- pH
- calcium status
- oxalate status
- citrate status
- uric acid status)
- low urine volume
- high pH
- hypercalciuria
- hyperoxaluria
- HYPOcitraturia
- hyperuricosuria
how do dietary sodium and protein intake affect urinary calcium?
increase
what is the inheritance of Dent disease?
x linked
what part of the nephron is affected in dent disease? what are the manifestations?
- proximal tubule
- hypercalciuria
- nephrocalcinosis
- nephrolithiasis
- kidney failure in 5th decade
what type of diuretics are used to treat calcium stones? why?
- thiazide
- reduces sodium presence, reducing calcium excretion due to mild volume depletion
what are the treatments for calcium oxalate stones?
- fluid
- diet
- thiazides
- potassium citrate
- bisphosphonates
fat malabsorption can lead to what type of stone? what is the pathogenesis?
- hyperoxaluria - calcium oxalate stones
- fat binds calcium, leaves oxalate free to form stones
what is the pathogenesis of medullary sponge kidney?
- dilatation of collecting ducts
- stasis
- calcium stones
