Renal12 Flashcards
What are the potential severe complications of kidney stones?
- Hydronephrosis
- Pyelonephritis
What is the composition of the 4 types of kideny stones? and the relative frequency?
- Calcium (80%)
- Ammonium Mg++ PO4- (struvite) (15%)
- Uric acid (5%)
- Cystine (1%)
What types are radiopaque on X-ray?
- Calcium
- Ammonium Mg++ PO4-
- Cystine
What do you see on X-ray for Uric acid stones?
NOTHING! (Radiolucent)
*Visible on CT and ultrasound
Calcium precipitates at?
High pH: calcium phosphate
Low pH: calcium oxalate
Ammonium Mg++ PO4- (struvite) preciptates at?
High pH
Uric acid precipitates at?
Low pH
Cystine precipitates at?
Low pH
Calcium oxalate crystals can result from?
- Hypercalcemic conditions
- Ethylene glycol (antifreeze)
- Vitamin C abuse
What is the most common kidney stone presentation?
Calcium Oxalate stone w
-Hypercalcium or Normocalcemia
What is the treatment for recurrent calcium stones?
Thiazides & citrate
What are “struvite” stones caused by?
Infection w/ urease positive bugs that hydrolyze urea to ammonia -> Urine Alkinalization
- Proteus mirabilis
- Staphylococcus
- Kliebsiella
“Struvite” stones associated with what?
Staghorn calculi
-can be nidus for UTIs
How do you treat Uric Acid stones?
Alkalinization of urine
When do you see Uric Acid stones?
- Strong association with hyperuricemia (e.g., gout)
- Diseases w/ HIGH cell turnover (e.g., leukemia)
How do you treat Cystine stones?
Alkalinization of urine
What is the shape of cystine stones?
Hexagonal crystals
Cystine stones are most often due to what?
2˚ cystinuria
Hydronephrosis:
-Characteristics
- Back-up of urine into the kidney
- Dilation of renal pelvis and calyces proximal to obstruction
- May resul in parenchymal thinning in chronic, severe cases
Hydronephrosis:
-Causes
- Urinary tract obstruction
- Vesicoureteral reflex
