Urinary tract calculi Flashcards
Define urinary tract calculi and what is it also known as?
It is the deposition of crystals in the urinary tract.
Also known as nephrolithiasis
What are the different types of stones? And what are they formed of?
- Calcium oxalate - formed from calcium
- Urate - formed from Urea (by product of purine breakdown)
- Struvite stone - formed from the breakdown of urea by bacteria (infection stones)
- Cysteine - formed of the amino acid cysteine
- Xanthine - formed from xanthine (by product of purine breakdown)
What is the most common type of stone?
- Calcium oxalate stones
What other condition may someone with a urate stone also have?
Gout
What are the risk factors for nephrolithiasis?
- Dehydration
- diet = rhubarb, tea and chocolate (for calcium oxalate) and red meat, shellfish (for urate)
- Urinary tract infections
- Obesity
What is the epidemiology of nephrolithiasis?
- Common
- 2 or 3 times more common in men
- More common in people with white ancestry
- Peak age 20-50yrs
What are the presenting symptoms of someone with urinary tract calculi?
- Often asymptomatic
- Severe loin pain - renal colic
- nausea and vomiting
- Cannot lie still
- Urinary frequency, urgency and retention
- Blood in urine
What are the signs of nephorlithiasis on physical examination?
- Loin and lower abdo tenderness
2. Signs of sepsis if obstruction - fever
What are the appropriate investigations for urinary tract calculi?
- Urinanalysis
- Bloods - U&Es
- non-contrast CT KUB
- USS
What is the management for nephrolithiasis?
- Hydration and pain control
- Antibiotic therapy
- Alpha blockers to promote removal
- Surgical removal
- Lithotripsy
What are the complications of urinary tract calculi?
- Pyelonephritis
- Septicaemia
- haematuria (post procedure)
What is the prognosis for nephrolithiasis?
Good
However high rate of recurrence (50% in the first 5 years)
