Renal Colic

Question 1

What is the most common cause?

Answer 1

Renal stones?

Question 2

Which type of stones are the most common?

Answer 2

Calcium oxalate (85%)

Question 3

Risk factors of calcium oxalate stones?

Answer 3

• Hyperparathyroidism (hypercalcaemia)
• Prolonged immobility – increased bone resorption
• Primary renal disease
• Dehydration
• Diuretics/steroids
• Recurrent UTIs
• Renal abnormalities – obstruction/stricture
• FHx

Question 4

Presentation?

Answer 4

Painless

Pain:
o Dull ache in Loin = stone in renal pelvis
o Severe colicky pain Loin to groin. Sudden onset = ureteric stone
o Suprapubic/perineal/testicular ache = bladder stone

Haemtauria
Infection symptoms

Question 5

Investigations? (3)

Answer 5

• U&E, glucose, FBC (HB and WCC), calcium
• Urine dipstick and MCS
• Radiology – AXR, ultrasound, CT

Question 6

Mx?

Answer 6

Analgesia: e.g. diclofenac (acute IM)
High fluid intake
Small stones will pass spontaneously. Larger ones may require surgery
Treat associated infection