Nephrolithiasis Flashcards
what is nephrolithiasis?
- kidney stones also called renal calculi
- stones develop in kidney can migrate out to anywhere in urinary tract
- stones in urinary tract (renal calculi)
who is more likely to get kidney stones?
-more likely in males (2-3X higher incidence in men)
where does nephrolithiasis originate?
-originates in the kidney (could have in both kidneys but generally in 1) then migrates then may cause obstruction
nephrolithiasis (kidney stones) the most common cause of?
nephrolithiasis (kidney stones) is the most common cause of obstruction in the urinary tract
what is the etiology of kidney stones?
- complex interaction:
- increase in concentration of precipitate components in blood & urine
- structural changes in urinary tract
- fluid, dietary & metabolic factors (what you eat is what you absorb is what you metabolize)
there are some things that prevent us from forming stones all the time, what are these?
- renal proteins inhibit crystallization
- presence of stone inhibitors eg. magnesium & citrate (prevent stones from forming)
what is the nidus or nucleus?
the first particle that begins to form stone
what is the patho of kidney stones
- increase in solute concentration & or urine stasis
- precipitation in urine
- nucleus (also called nidus) forms around which other components will accumulate
- crystallization
there are _____ types of kidney stones
4
what are the 4 types of kidney stones?
- calcium (oxolate & phosphate)
- magnesium ammonium phosphate (strurite)
- uric acid (urate)
- cystine
calcium (oxolate & phosphate ) stones
Contributing factors:
- hypercalcemia & hypercalciuria
- immobilization
- hyperparathyroidism
- vitamin D intoxication
- diffuse bone disease
- Milk-alkali syndromes
- renal tubular acidosis
- hyperoxaluria
- intestinal bypass surgery
Treatment:
- treatment of underlying conditions
- increased fluid intake
- thiazide diuretics
- dietary restriction of foods high in oxalate
mnfts of nephrolithiasis (kidney stones)
- very severe colicky pain (minutes to days): intermittent because hurts as stone moves, ureter or urethra distention d/t migration of stone
- non colicky pain (distention of renal pelvis & calyces stone not attempting to pass
- N&V from severe pain
Magnesium ammonium phosphate (strurite) stones
Contributing factors:
-urea-splitting urinary tract infections
Treatment:
- treatment of urinary tract infection
- acidification of urine
- increased fluid intake
uric acid (urate) stones
Contributing factors:
- formed in acid urine with pH of approx 5.5
- gout
- high purine diet
Treatment:
- increased fluid intake
- allopurinol for hyperuricosuria
- alkalinization of urine
cystine stones
Contributing factors:
-cystinuria (inherited disorder of amino acid metabolism)
Treatment:
- increased fluid intake
- alkalinzation of urine