Renal stones Flashcards
What are the types of renal stones?
Calcium oxalate
Calcium phosphate
Uric acid
Struvite- associated with infection
Cystine - associated with cystinuria (autosomal recessive condition)
What are the most common kind of renal stones?
Calcium stones - calcium oxalate and calcium phosphate
What is the presentation of renal stones?
Renal colic
Haematuria
Nausea and vomiting
Reduced urine output
Symptoms of sepsis if infection is present
What investigations are performed in investigation of renal stones?
Urine dipstick - haematuria
U&E
FBC - signs of infection
Abdominal X-ray - can show calcium based stones
Non-contrast CT-KUB - initial investigation of choice
What is the management of renal stones?
NSAIDs for analgesia
Antiemetics
Antibiotics if infection present
Tamsulosin
Surgical intervention - for stones larger than 10mm, stones that do not pass spontaneously, or where there is complete obstruction, or infection
What types of surgery are available for renal stones?
ESWL - extracorporeal shock wave lithotripsy
Ureteroscopy and laser lithotripsy
PCNL - percutaneous nephrolithotomy
Open surgery
What analgesia is preferred in renal colic?
Diclofenac
What is the management of stones under 5mm?
Watchful waiting
What is the management of 5-10mm renal stones?
Shockwave lithotripsy
What is the management of 10-20mm renal stones?
Shockwave lithotripsy or ureterosopy
What is the management of renal stones >20mm?
Percutaneous nephrolithotomy
What medications can be used to prevent calcium stone formation?
Potassium citrate
Thiazie diuretics
