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KIDNEY STONES - Coggle Diagram
KIDNEY STONES
ETIOLOGIES
Mostly calcium stones (particularly calcium oxalate)
Due to supersaturation of the urine
Risk factors
Excess calcium intake
Low water intake
Abnormal urine pH
Hyperparathyroidism
Changes in urine pH can make precipitation likely
INVESTIGATIONS/PRESENTATION
Lab testing
Urinalysis for hematuria and other signs of UTI
Assessment of kidney function
Diagnostic imaging
CT to predict mineral composition (stones are radiopaque)
Ultrasound is second choice
Can sometimes be asymptomatic
Symptoms
Pain: 20-60 minute paroxysms due to distension of kidney capsule
Hematuria in the majority of symptoms
Nausea/vomiting
Dysuria and urinary urgency
DEFINITION
Renal calculi
Nephrolithiasis
Crystals that form in the urine
Calcium oxalate
Uric acid
Calcium phosphate
Cystine (rare)
TREATMENT
Acute
NSAIDs/opioids for pain
Most stones pass without intervention
straining of urine
Long-term/surgical
Surgery if
Obstructing stones and suspected/confirmed UTI
Bilateral obstruction and AKI
unilateral obstruction and solitary functioning kidney
Shock wave lithotripsy
Ureteroscopy
Nephrolithotemy