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]

• Severe Pain

  In renal colic there is generally severe pain leading from the kidneys down through the abdomen and groin. [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]

  Some people with severe pain from kidney stones need to stay in the hospital. You may need to get fluids through an IV into your vein. [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

  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]

  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]

  (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]

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

  Kidney stone pain may be accompanied by other signs and symptoms like nausea, vomiting, dizziness, bloody urine (hematuria), straining and pain/burning upon urination. [healthhype.com]

• Abdominal Pain

  Patients receiving a high dose of ceftriaxone and developing colicky abdominal pain should be considered for ultrasound and a change in antibiotic therapy if appropriate. [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]

  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. [academictransfer.com]

• 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]

  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]

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

• Severe Abdominal Pain

  Symptoms range from severe abdominal pain or pain in the side or back, blood in the urine, fever and nausea. Kidney Biology 101 The kidneys produce the urine that dissolves wastes and excretes them through the urinary tract. [totalhealthmagazine.com]

  Doctors need to differentiate stones from other possible causes of severe abdominal pain, including Helical (also called spiral) computed tomography (CT) that is done without the use of radiopaque contrast material is usually the best diagnostic procedure [merckmanuals.com]

  In patients older than 60 years presenting with severe abdominal pain and with no prior history of renal stones, look carefully for physical signs of abdominal aortic aneurysm (AAA) (see Abdominal Aortic Aneurysm ). [emedicine.medscape.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]

• Papule

  Diagnosis of PXE was made by yellow papules on the neck and ophthalmologic angioid streaks. This diagnosis was confirmed by a skin biopsy (Von Kossa stain) and by genotyping analysis of ABCC6 (homozygous mutation R1138Q). [ncbi.nlm.nih.gov]

• 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]

• Kidney Failure

  Are in kidney failure, and have not had a liver biopsy or DNA testing but also have very high blood oxalate levels and evidence of oxalate deposits in body tissues. [rarediseasesnetwork.org]

  Besides pain (often described as the worst ever experienced), stones lead to costly surgical interventions, loss of work and the long-term complication of kidney failure, requiring dialysis or transplantation. [mayo.edu]

  Furth CJASN March 2016, 11 (3) 488-496; DOI: Add to Selected Citations Predictors of Incident ESRD among Patients with Primary Hyperoxaluria Presenting Prior to Kidney Failure Fang Zhao, Eric J. Bergstralh, Ramila A. Mehta, Lisa E. Vaughan, Julie B. [cjasn.asnjournals.org]

  By 15 years of even mild high calcium, 80% of patients will have some renal failure, usually it is Stage III kidney failure at this time. We have a blog discussing kidney failure and stones which includes x-rays and pictures. [parathyroid.com]

  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]

• 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

  Anubha Sikka Indications • Patient c/o left renal pain with mild burning micturition • Investigations- USG abdomen • Left ureterovesical junction causing mild hydroureteronephrosis, 7mm in size at lower end of left ureter Prescription Berb vulgaris 30 [de.slideshare.net]

  Spinal transmission of renal pain signals occurs primarily through the ascending spinothalamic tracts. Nephrolithiasis: acute renal colic. Nerve supply of the kidney. Nephrolithiasis: acute renal colic. Nerve supply of the kidney. [emedicine.medscape.com]

  MalaCards based summary : Nephrolithiasis, Calcium Oxalate, also known as nephrolithiasis, is related to nephrolithiasis, uric acid and nephrolithiasis/osteoporosis, hypophosphatemic, 1, and has symptoms including renal pain An important gene associated [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]

  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]

  Contd…  Urinalysis :hematuria and pyuria; pH 5.5 indicates uric acid stone; 7.5 indicates struvite stone; urine culture and drug sensitivity studies to detect infection.  Serum kidney function tests, electrolytes, calcium, phosphorus, uric acid, and [slideshare.net]

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

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]

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]

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]

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]

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

With our evolving understanding of the epidemiology, biology, and genetics of nephrolithiasis and the advances in therapeutic technologies, we have made significant progress in patient care. [intechopen.com]

Open access peer-reviewed Edited Volume Pathophysiology, Genetics, and Treatment Modalities In recent decades, we have enhanced our understanding of the pathophysiology and genetics of rare and common causes of kidney stones. [intechopen.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]

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]