Nephrolithiasis Flashcards
What are the major 4 types of stones?
- Calcium (80%)- CaOxalate, CaPhosphate
- Uric Acid stones (7%)
- Struvite Stones (10-15%)
- Cysteine Stones (1%)
What organisms make strive stones, and which main organism does not?
- Proteus mirabilis and Klesiella make it
2. E. Coli does NOT
Risk factors for kidney stones?
- Hyperparathyroidism
- Renal Tubular Acidosis
- Gout
- Diabetes
- Highprotein/High Sodium Diets
- Inflammatory Bowel Disease
What initial lab tests should you do for stones?
Calcium, parathyroid hormone, & uric acid
What type of urine tests should patients with recurrent stones have?
24 hour urine test x 2
- Calcium
- pH
- Calcium
- Citrate
- Creatinine
- Sodium
What is the gold standard for diagnosis of kidney stone?
Helical CT scan
Size of stones and relation to spontaneous passing?
<5 mm= 90% pass rate
5-7mm= 50% pass rate
>7 mm= rarely passes
How much fluid should patients with kidney stones drink?
2.5 L/day
What mediations can be given to help the stone pass?
CCB, peripheral beta blockers, and alpha 1 antagonists
Should you restrict calcium for patients with calcium stones?
No, it may result in bone mineralization and increase risk for nephrolithiasis.
What diet modifications should person have with kidney stones?
- Low sodium
- Low Oxalate- beets, rhubarb, spinach, greens, okra, tea, chocolate, cocoa, and nuts
- Low protein
Four different tests and the levels for calcium stone formation?
- Hypercalcuria
- Hypocitraturia
- Hyperoxaluria
- Hyperuricosuria
What do you do for hypercalcuria?
- Thiazide diuretics
2. NORMAL calcium intake
What do you do for hypocitraturia?
potassium citrate- it inhibits the precipitation of calcium oxalate
What do you do for hyperoxaluria?
- usually with malabsorption from gut
- Can do oxalate binders such as calcium carbonate or cholestyramine
