For patients presenting with acute renal colic, especially those with body mass index of KEYWORDS: Computed tomography; Imaging technique; Ionizing; Kidney stones; Nephrolithiasis; Radiation exposure [ncbi.nlm.nih.gov]

• Pain

  A Caucasian man aged 25 years had sudden bilateral inguinal and occasional periumbilical pain. [ncbi.nlm.nih.gov]

  Kidney Stone Pain (Renal Colic) Kidney stone pain, or renal colic, is the pain caused by the passage of a kidney stone through the urinary tract. As a stone forms in the kidney, it usually does not cause pain. [healthhype.com]

  […] urine Abdominal pain Painful urination Excessive urination at night Urinary hesitancy Testicle pain Groin pain Fever Chills Abnormal urine color Signs and tests Pain may be severe enough to require narcotics. [endocrinesurgery.ucla.edu]

  Whereas the pain of biliary or intestinal colic is intermittent, the pain of renal colic is more constant but there are often periods of relief or just a dull ache before it returns. The pain may change as the stone moves. [patient.info]

  This pain may last from half an hour to several hours. [henriettes-herb.com]

• Severe Pain

  Others, however, can have severe kidney pain, infection, and inflammation. The most severe pain occurs where the passage of urine from the kidney is obstructed by the stone. Treatment includes medications to clear up infections and to relieve pain. [britannica.com]

  The medical term for kidney stones is nephrolithiasis, and if they cause severe pain it's known as renal colic. Symptoms of kidney stones Small kidney stones may go undetected and be passed out painlessly in the urine. [nhs.uk]

  A small stone may pass out without causing symptoms but if it grows to more than 5mm it can cause severe pain. Hope you enjoy the video and understand the genesis and management of kidney stones. [uskeys.net]

  The main symptom is severe pain that starts and stops suddenly: Pain may be felt in the belly area or side of the back. Pain may move to the groin area ( groin pain ), testicles ( testicle pain ) in men, and labia (vaginal pain) in women. [medlineplus.gov]

• Nausea

  A 64-year-old man with HIV on antiretroviral therapy (including atazanavir, a protease inhibitor) presented with left flank pain, nausea and vomiting. [ncbi.nlm.nih.gov]

  Diagnosis and differential diagnosis Diagnostic criteria Signs and symptoms of nephrolithiasis include: Sudden onset of severe pain, arising from the flank and radiating to the groin Possible writhing and pacing, depending on level of obstruction Nausea [cancertherapyadvisor.com]

  Administer anti-emetics as indicated for nausea. Maintaining Urine Flow 1. Administer fluids orally or I.V. (if vomiting) to reduce concentration of urinary crystalloids and ensure adequate urine output. 2. [slideshare.net]

  Nausea and vomiting are common. Renal Calculi [omicsonline.org]

• Vomiting

  Management Antepartum/Intrapartum/Postpartum Obtain IV access and aggressive hydration (patients often have dehydration due to vomiting and decrease po intake). IV narcotics (Morphine, meperidine, or butorphanol are most common) for pain control. [cancertherapyadvisor.com]

  A 64-year-old man with HIV on antiretroviral therapy (including atazanavir, a protease inhibitor) presented with left flank pain, nausea and vomiting. [ncbi.nlm.nih.gov]

  (if vomiting) to reduce concentration of urinary crystalloids and ensure adequate urine output. 2. Monitor total urine output and patterns of voiding. Report oliguria or anuria. 3. [slideshare.net]

  On June 17th precursors of another attack ; on the 18th vomiting accompanied by all the frightful circumstances which I have detailed above ; the vomiting of mucus, bile, ingesta, continued at short intervals until the 26 th ; my tongue was coated with [homeoint.org]

  Nausea and vomiting are common. Renal Calculi [omicsonline.org]

• Abdominal Pain

  Due to its variable presentations, it is usually discovered incidentally, especially when investigating patients for abdominal pain. [ncbi.nlm.nih.gov]

  flank pain, upper abdominal pain Middle section of ureter Renal colic, anterior abdominal pain, flank pain Distal ureter Renal colic, dysuria, urinary frequency, anterior abdominal pain, flank pain Distal ureteral stones may be manifested by bladder [aafp.org]

  Anahtar Kelime:Nephrolithiasis,Abdominal Pain,Acute Renal Artery Thrombosis [atif.sobiad.com]

  Patients with kidney stones often present with renal colic, hematuria or vague abdominal pain, acute abdominal or flank pain, nausea, difficulty urinating, penile pain or testicular pain. [radboudumc.nl]

• Suprapubic Pain

  CONCLUSIONS: Nephrolithiasis is a rare complication of pediatric DKA, and should be considered in children with DKA who develop hematuria, flank pain, or suprapubic pain. [ncbi.nlm.nih.gov]

  Suprapubic pain along with urinary urgency and frequency suggests a distal ureteral, ureterovesical, or bladder calculus (see Obstructive Uropathy: Symptoms and Signs). [msdmanuals.com]

  These symptoms include suprapubic pain, urinary frequency, urgency, dysuria, stranguria, pain at the tip of the penis, and sometimes various bowel symptoms, such as diarrhea and tenesmus. [emedicine.medscape.com]

• Right Flank Pain

  A 36-year-old man was admitted to hospital due to right flank pain as a result of ureteral stones. He had been followed up for type 1 glycogen storage disease since the age of 11 years. [ncbi.nlm.nih.gov]

  After 8 months of treatment with dorzolamide, she noted polyuria and right flank pain, which prompted her to seek evaluation by a local physician. [jamanetwork.com]

  Case A 39-year-old woman presented to the ED with a chief complaint of intermittent right flank pain that radiated into her groin area. She stated the pain had begun suddenly, 4 hours prior to arrival, and was accompanied by nausea and vomiting. [mdedge.com]

• Tachycardia

  Dysuria (burning pain on micturation) Tachycardia Decreased blood pressure – can lead to septic shock. [almostadoctor.co.uk]

  Obtain vital signs, and monitor for fever and symptoms of impending sepsis (tachycardia, hypotension). [slideshare.net]

  This may be accompanied by nausea, vomiting, tachycardia Bladder stone Characterised by dysuria( pain or burning during micturition), frequency and urgency 6. [de.slideshare.net]

  Vital signs during an episode of renal colic may indicate hypertension and tachycardia, but patients should not be febrile. Fever may suggest UTI, pyelonephritis or even pyonephrosis if kidney is obstructed. [cancertherapyadvisor.com]

• Agitation

  The patients are usually restless and agitated. Diagnosis & Laboratory Investigations of Nephrolithiasis Urine Examination Image: “Calcium oxalate crystals: Envelope and dumbbell shaped crystals in the urine” by Doruk Salancı. [lecturio.com]

• Hematuria

  There was a family history of renal stones in both maternal and paternal grandparents and of microscopic hematuria in the mother. There was no associated urinary flow obstruction and the hematuria remitted spontaneously. [ncbi.nlm.nih.gov]

• Flank Pain

  A 64-year-old man with HIV on antiretroviral therapy (including atazanavir, a protease inhibitor) presented with left flank pain, nausea and vomiting. [ncbi.nlm.nih.gov]

  The authors review appropriate workup and treatment for patients presenting with signs and symptoms of flank pain consistent with renal colic. [mdedge.com]

  flank pain, upper abdominal pain Middle section of ureter Renal colic, anterior abdominal pain, flank pain Distal ureter Renal colic, dysuria, urinary frequency, anterior abdominal pain, flank pain Distal ureteral stones may be manifested by bladder [aafp.org]

• Kidney Failure

  APRT Deficiency APRT deficiency is a disorder that causes kidney stones, and chronic kidney disease leading to kidney failure in some cases. The stones are made up of 2,8 dihydroxyadenine (DHA), and can be confused with uric acid. [rarediseasesnetwork.org]

  Risk of end-stage renal failure (ESRD) Principal investigator: Andrew D. Rule, M.D. [mayo.edu]

  If stones are severe, persistent, or come back again and again, there may be signs of kidney failure. Straining the urine may capture urinary tract stones when they are excreted. Analysis of the stone shows the type of stone. [endocrinesurgery.ucla.edu]

  If the obstruction is long (more than 2-3 weeks), the high pressure can cause irreparable damage to the kidney tissue (see chronic kidney failure). [healthanddisease.com]

• Microscopic Hematuria

  There was a family history of renal stones in both maternal and paternal grandparents and of microscopic hematuria in the mother. There was no associated urinary flow obstruction and the hematuria remitted spontaneously. [ncbi.nlm.nih.gov]

  Gross or microscopic hematuria is found in 33% to 90% of children who have urolithiasis and occurs equally across age groups. Urinary tract infection frequently is the presenting sign of urolithiasis in preschool-age children. [pedsinreview.aappublications.org]

  The STONE score was mentioned. 08:30 Q2: Can you address generalizability issues in this 15-center study whereby the cohort has 40% with a history of previous kidney stones and only 60% demonstrating microscopic hematuria. [aliem.com]

• Renal Pain

  Tenesmus after urination TABACUM Renal colic usually left sided. Violent pain along the ureter. Sometimes associated with vertigo and vomiting THUJA OCCIDENTALIS Renal calculus usually left sided. Frequent urination accompanying pain 3 12. [de.slideshare.net]

  Development of renal colic pain and renal damage The colicky-type pain known as renal colic usually begins in the upper lateral midback over the costovertebral angle and occasionally subcostally. [emedicine.medscape.com]

  Kidney stones can cause abdominal or back pain (known as renal colic). Renal colic usually begins sporadically but then becomes constant and can lead to nausea and vomiting. The site of pain can change as the stone moves through the urinary tract. [malacards.org]

All patients were seen at least twice and had undergone a metabolic workup. RESULTS: A total of 260 return patients were seen during the period 2010-2015. The male:female ratio was 3.1:1. Mean age at the first stone event was 44.1 years. [ncbi.nlm.nih.gov]

The authors review appropriate workup and treatment for patients presenting with signs and symptoms of flank pain consistent with renal colic. [mdedge.com]

The first kidney stone in a child prompts a more complete workup. [arupconsult.com]

References:[1][7] Diagnostics Initial diagnostic workup includes imaging studies to locate the stone and laboratory tests to determine kidney function and assess for UTI. [amboss.com]

• Nephrolithiasis

  The aim of this study was to compare urine and serum metabolic compositions in IPAA patients with nephrolithiasis and controls with IPAA and no nephrolithiasis. [ncbi.nlm.nih.gov]

• Pyuria

  The presence of pyuria, however, has only moderate accuracy in identifying UTIs in patients with kidney stones.4 If an infected stone cannot be excluded clinically, computed tomography (CT) is indicated. [mdedge.com]

  Laboratory tests ↑ WBC: suggests concomitant UTI ↑ Serum urea nitrogen and creatinine: suggests acute kidney injury Urine dipstick and urinalysis Gross or microscopic hematuria Pyuria, positive leukocyte esterase, positive nitrites, or bacteriuria (suggests [amboss.com]

  He is of feeble health usually or disabled for active labor, has backache or constant pain and hematuria or pyuria. [henriettes-herb.com]

  Pyuria with or without bacteria may be present. Pyuria suggests infection, particularly if combined with suggestive clinical findings, such as foul-smelling urine or a fever. [msdmanuals.com]

  Midstream specimen of urine for microscopy (pyuria suggests infection), culture and sensitivities. Blood for FBC, CRP, renal function, electrolytes, calcium, phosphate and urate, creatinine. [patient.info]

• Hypouricemia

  […] idiopathic hypercalciuria, renal hypophosphatemia, renal tubular acidosis, idiopathic infantile hypercalcemia, Dent disease, familial hypomagnesemia with hypercalciuria and nephrocalcinosis, hypocitraturia, cystinuria, primary hyperoxaluria and renal hypouricemia [ncbi.nlm.nih.gov]

  renal, 2 SLC12A1 Bartter syndrome SLC22A12 Hypouricemia, renal 1 SLC26A1 Nephrolithiasis, calcium oxalate SLC34A1 Nephrolithiasis/osteopetrosis, hypophosphatemic,1 SLC34A3 Hypophosphatemic rickets with hypercalciuria UMOD Hyperuricemic nephropathy, [invitae.com]

After two extracorporeal shock wave lithotripsy treatments disintegration of the stone was not detectable. [ncbi.nlm.nih.gov]

The use of a mobile machine may affect options for emergency treatment, but may also add to waiting times for non-emergency treatment URS for renal and ureteric stones is increasing (there has been a 49% increase from 12,062 treatments in 2009/10, to [gpnotebook.co.uk]

The prognosis for squamous cell carcinoma is poor, but stage for stage the prognosis is not different between patients with urothelial carcinoma and squamous cell carcinoma of the renal pelvis and ureter. [scienceopen.com]

If pyelitis or hydronephrosis occur, the prognosis is unfavorable. [henriettes-herb.com]

It is clinically important to identify the stone type, which informs prognosis and selection of the optimal preventive regimen. [accessmedicine.mhmedical.com]

Median age at diagnosis was significantly lower in the study’s first half (5 vs 10 years; p=0.019) and an infectious etiology was more frequent (p=0.043). [scielo.mec.pt]

Less common stones Calcium phosphate stones Etiology Hyperparathyroidism Type 1 renal tubular acidosis Specific preventive measures Thiazide diuretics Urine acidification Cystine stones Etiology: hereditary defect in renal tubular absorption of dibasic [amboss.com]

No etiological agent for the rapidly recurring concrements could be detected until Ureaplasma urealyticum cultures were performed at the time of the seventh operation. [ncbi.nlm.nih.gov]

The Epidemiology of Nephrolithiasis and Chronic Kidney Disease Project investigates underlying pathogenic factors to explain this association. [mayo.edu]

Electronic address: [email protected] 2 Division of Urology and Epidemiology, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, USA; Division of Urology and Center for Pediatric Clinical [ncbi.nlm.nih.gov]

Owing to the absence of a central registry, data on overall epidemiology of AKI are scanty from India. [unboundmedicine.com]

We use this case to illustrate the pathophysiology of indinavir stones and hypothesize how they can occur years after discontinuation by discussing the pharmacokinetics of the drug. [ncbi.nlm.nih.gov]

PATHOPHYSIOLOGY• Slow urine flow, resulting in supersaturation of the urine with the particular element that first become crystallized and later become stone 11. PATHOPHYSIOLOGY• Damage to the lining of the urinary tract 12. [slideshare.net]

Adequate water intake is the most important conservative strategy in urolithiasis prevention; particularly hydropinotherapy with oligomineral water should be considered as an important instrument to prevent stones in subjects predisposed to the disease [ncbi.nlm.nih.gov]

This book discusses in further details, the risk factors, treatment options and ways to prevent nephrolithiasis. (Imprint: Nova Biomedical) Preface An Overview of Nephrolithiasis Risk Factors, Prevention and Management (Monica C. Chiang, Taniya N. [novapublishers.com]

PREVENTION• Low-calcium diets are not generally recommended,except for true absorptive hypercalciuria. [slideshare.net]

It is clinically important to identify the stone type, which informs prognosis and selection of the optimal preventive regimen. [accessmedicine.mhmedical.com]

The most important preventive measure is adequate hydration. [amboss.com]