Renal Colic

Question 1

Define renal colic.

Answer 1

Generally describes an acute and severe loin pain caused when a urinary stone moves from the kidney or obstructs the flow of urine through the ureter.

Question 2

Give 3 causes of renal colic.

Answer 2

1. Urinary tract stones.
2. UTI.
3. Pyelonephritis.

Question 3

Clinical presentation of renal colic.

Answer 3

• Rapid onset - woken from sleep
• Pain that results from upper urinary tract obstruction
• Excruciating ureteric spasms - patient is writhing in pain
• Pain is from loin to groin and comes and goes in waves as the ureters peristalise
• Associated with nausea and vomiting
• Worse with fluid loading
• Radiates to groin and ipsilateral testis/labia
• Often cannot lie still (differentiates from peritonitis)

Question 4

Complications of renal and ureteric stones.

Answer 4

​​​​​​The main complications of renal and ureteric stones are obstruction of urinary flow and infection.
Others:
- Renal carcinoma
- CKD
- CHD
- Rupture

Question 5

What investigations might you do to find out what is causing someone’s renal colic?

Answer 5

1. Bloods - inc. calcium, phosphate and urate.
2. Urinalysis.
3. MCS MSU.
4. NCCT-KUB - gold standard!

Question 6

Describe the treatment for renal colic.

Answer 6

1. Strong analgesia e.g. NSAIDs (IV diclofenac).
2. Anti-emetics.
3. Check for sepsis.