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Renal Colic & Stones (Risk factors & aetiology (Hypercalcaemia,…
Renal Colic & Stones
Key Facts
Renal stones (calculi) consist of crystal aggregates, stones form in collecting ducts and may be deposited anywhere from the renal pelvis to the urethra
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Risk factors & aetiology
Hypercalcaemia, hyperuxaluria, hypercalcuria, hyperuricaemia
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Anatomical abnormalities that predispose to stone formation e.g. duplex, obstruction or trauma
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Pathophysiology
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Stones regularly cause obstruction, leading to hydronephrosis; a combination of obstruction and dilation of renal pelvis that often causes lasting damage to the kidney
Stones form because solute concentrations exceed saturation, often in the context of a trigger that starts crystallisation
Clinical Presentation
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If urinary tract is obstructed then fluid/diuretics make the pain worse as peristaltic flow increases
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If urinary tract obstruction and infection are present then may get acute pyelonephritis - fevers, rigors, loin pain, nausea and vomiting
Dysuria, strangury, frequency
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Diagnosis
Bloods
Serum urea, electrolyte, creatinine and calcium
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Urine dipstick
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Also looks for red cells, protein and glucose
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Treatment
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If not passing: shockwave lithotripsy, endoscopy
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