Renal and Urinary Calculi

Question 1

What is nephrolithiasis?

Answer 1

Formation of insoluble stones (kidney stones or calculi) in the kidneys.

Question 2

What is urolithiasis?

Answer 2

Stones that move into the urinary tract (ureter) or form in the bladder.

Question 3

What are the factors that contribute to renal stone formation?

Answer 3

1) high concentration of stone components in the urine that can’t be dissolved (supersaturation)

2) volume of solvent (e.g. dehydration)

3) Impaired urine flow (urine stasis, obstruction)

4) urine pH (normal is 6-7.5)

Question 4

What is renal colic?

Answer 4

Pain that occurs with the passage of a stone or d/t peristalsis through an obstructed ureter. Pain is typically unilateral, located in teh flank region, and may radiate down toward the groin, perineal area or inner thigh. Pain described as moderate to severe and colicky (waxes and wanes).

Question 5

What is flank pain?

Answer 5

Not colicky - caused by urinary tract obstruction. When urine passage is blocked, pressure builds up in teh renal pelvis an dcalyces causing dilation (hydronephrosis), which distends the renal capsule and causes localized flank pain. Hydronephrosis may decrease urine output (mainly when bilateral). Patient may present with costovertebral angle tenderness.

Question 6

What is the main prophylactic intervention recommended for all types of stones?

Answer 6

Increase water intake with goal of urine volume = 2 L/day.

Question 7

What are the goals of treatment for stones?

Answer 7

1) decrease the symnptoms and complications arising from existing renal stones
2) prevent subsequent recurrence