Renal Calculi (Nephrolithiasis) Flashcards
renal calculi
kidney stones in urinary tract
- more common in men
- originates in 1 kidney (asympt) until migrates & causes obstr
etiology
complex interaction
- inc precipitable components (ex. calcium, carbonate, phosphate)
- structural changes in urinary tract (ex. BPH)
- diet, fluid intake, rate of excretion, metabolic factors
patho
inc conc of solute and/or urine stasis results in precipitation of solute within the urine and likely formation of stones
kidney’s defence mechanism to inhibit crystallization & formation of stones
- kidney produces proteins that inhibit crystallization of components in urine (inadequate/defective proteins will lead to crystallization)
- presence of stone inhibitors in urine (ex. magnesium and citrate) –> inhibits urine & formation of stones
what to stones requires to form
a tiny particle (aka nucleus or nidus, and other precipitable components that gather around to form the stone
stag horn calculus
shape and size of stone
mnfts
- intermittent renal colicky pain
- ureter distention
- non-colicky pain –> distention of renal pelvis & calyces
- N/V
why does ureter distention mnft
d/t migration
Dx
- pattern of pain
- U/S, CT
- urinalysis
- IVP (intravenous pyelogram)
where is pain usually located
lower back radiating to groin
urinalysis purpose
determine if infection/kidney fx
IVP (intravenous pyelogram)
contrast medium into vein flows to urethra to visualize stone
Tx
- pain relief ASAP
- antispasmodics (for colicky pain)
- address N/V
- treat underlying cause
- small stones (<5mm) passed in urine
- larger stones: high-frequency sound waves
high-frequency sound waves Sx
sound waves break stone into fragments which get passed into the urethra
