SM 216a - Kidney Stones

Question 1

List the kidney stones in order of prevalence

Answer 1

Ca2+ containing stones >>>>>>>

Struvite stones > Uric acid stones > cysteine stones

Question 2

Does this condition promote or inhibit kidney stone formation?

High citrate

Answer 2

Inhibits stone formation

Question 3

What are the general risk factors for kidney stone formation?

Answer 3

• Low urine volume
• High sodium diet
  
  • Leads to increased urinary Ca2+
    
    • Reabsorption of Na+ and Ca2+ are coupled
    • High sodium diet
• *->** **decreased Na+ reabsorption
• > decreased Ca2+ reabsorption**
• High protein diet
  
  • Protein metabolism
  • -> Increased acid load
  • -> Bone resorption to buffer acid = Ca2+ release
  • -> Increased urinary Ca2+

Question 4

What kind of kidney stones are hexagonal?

Answer 4

Cysteine stones

Question 5

What are the risk factors for cysteine kidney stones?

Answer 5

Inherited disorder of metabolism that impairs cysteine reabsorption in the proximal tubule

Question 6

What are the major risk factors for uric acid stone formation?

Answer 6

• Hyperuricosuria
  
  • Increased dietary intake of purines and animal protein
  • High-cell turnover states: uric acid is released from cells when they die
    
    • Hematologic malignancies
    • Tumor-lysis syndrome
• Low urinary pH
  
  • Uric acid is less soluble in acidic conditions

Question 7

What kind of kidney stone is this?

Answer 7

Struvite

Rectagular, “coffin lid”

Question 8

What kind of kidney stone is this?

Answer 8

Calcium stone

Square shaped, looks like an envelope

Question 9

What kind of kidney stone is this?

Answer 9

Uric acid

Diamond/rhomboid shape