Renal Calculi Flashcards
Define renal calculi.
Renal calculi refers to the presence of crystalline stones within the urinary system (kidneys and ureter).
Explain the aetiology/risk factors of renal calculi.
High protein intake
High salt intake
White ancestry
Male sex
Dehydration
Obesity
Crystalluria
Summarise the epidemiology of renal calculi.
The lifetime prevalence of renal calculi is estimated to be between 5% and 12%, with the probability of having a stone varying according to age, gender, race, and geographical location. Renal calculi typically affects adult men more commonly than adult women, with a male to female ratio of 2 or 3:1.
Recognise the presenting symptoms of renal calculi. Recognise the signs of renal calculi on physical examination.
Acute, severe flank pain
Previous episodes of nephrolithiasis
Nausea and vomiting
Urinary frequency/urgency
Haematuria
Testicular pain
Obesity
Identify appropriate investigations for renal calculi and interpret the results.
Low radiation CT KUB
Pelvic USS
Urinalysis
FBC
Serum electrolytes, urea, and creatinine
Urine pregnancy test
Stone analysis
Generate a management plan for renal calculi.
Conservative management
Surgical decompression and management:
ESWL
PCNL
Laser
Identify the possible complications of renal calculi and its management.
Post PCNL bleeding
Post ESWL haematoma
Post-ESWL, PCNL, or ureteroscopy treatment urosepsis
Post-ESWL steinstrasse
Post-ESWL, PCNL, or ureteroscopy ureteric injury
Visceral organ injury
Pneumothorax
Ureteric stricture
Summarise the prognosis for patients with renal calculi.
The rate of recurrence of renal calculi in first-time stone formers is 50% at 5 years and 80% at 10 years. The patients at highest risk for recurrence are frequently those who are not compliant with medical therapy and dietary/lifestyle modifications, or where underlying metabolic abnormalities exist. Residual stone fragments from surgery will usually spontaneously pass as long as their size is <4 mm.
