Renal Calculi

Question 1

What is another name for renal calculi?

Answer 1

• nephrolithiasis

- kidney stones

Question 2

Are renal calculi on found in the kidney?

Answer 2

no, they can migrate within the urinary tract

Question 3

Are renal calculi more common in men or women?

Answer 3

men

Question 4

What causes renal calculi?

Answer 4

complex interaction of different factors:

• structural changes in urinary tract (ex. BPH)
• increase in concentration of blood/urine components (hypertonic urine)
• dietary and metabolic factors

Question 5

What is the pathology of renal calculi?

Answer 5

• kidney normally secretes 3 proteins that inhibit crystallization of components in urine
• increase in solute concentration and/or urine stasis > precipitators in urine > nucleus > crystallization

Question 6

What are 4 types of kidney stones?

Answer 6

• calcium (oxalate and phosphate)
• magnesium ammonium phosphate
• uric acid (urate)
• cystine

Question 7

What are manifestations of kidney stones?

Answer 7

• severe renal colic (spasmodic pain lasting minutes-days) from migration of the stone and distended ureter
• non-colicky pain from distention of renal pelvis and calyces
• nausea, vomiting, diaphoresis from pain

Question 8

How is a kidney stone diagnosed?

Answer 8

• exclude other issues (gallbladder problems, appendicitis)
• pain pattern can exclude appendicitis (not migratory)
• ultrasound, CT scan
• urinalysis (microscopic)
• IVP = intravenous pyelogram (contrast medium given IV and then x-ray to show where obstruction is)

Question 9

How are renal calculi treated?

Answer 9

• treat the pain and nausea (morphine and gravol)
• in 90% of cases the stone is small (will pass spontaneously)
• antispasmodics to relax muscles (ex. buscopan)
• if cause can be determined, may need to change diet
• surgery for larger stones