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Renal Stone

Kidney Stone


Presentation

  • She presented with a two day history of right flank pain that was treated initially as a renal stone. Further investigations confirmed her as a case of renal infarction.[ncbi.nlm.nih.gov]
  • A case report of a gouty patient with a transplanted cadaveric kidney is presented.[ncbi.nlm.nih.gov]
  • METHODS: A retrospective hospital note review of children presenting with kidney stones during the last 22 years (1993-2015) was conducted.[ncbi.nlm.nih.gov]
  • Free ureteric reflux was present, which allowed retrograde irrigation of the stone by infusion of hemiacidrin solution into the ileal conduit.[ncbi.nlm.nih.gov]
  • In the present study, no significant relationship was found between the presence of CAC in the patients with renal stones and the control group. However, there was a trend for higher prevalence of CAC in renal stone patients.[ncbi.nlm.nih.gov]
Splenectomy
  • A 27-year-old woman with idiopathic thrombocytopenic purpura (ITP), which had relapsed following splenectomy, was found to be refractory to a wide range of individual immunosuppressive agents.[ncbi.nlm.nih.gov]
  • A few hours after laparoscopy, one patient underwent splenectomy because of significant hemorrhage from a splenic laceration (grade IIIb complication).[ncbi.nlm.nih.gov]
Severe Abdominal Pain
  • Three months after initiating the ketogenic diet, she developed severe abdominal pain and vomiting. The spot urine calcium-to-creatinine (Ca/Cr) ratio and 24-hour urine evaluation showed hypercalciuria.[ncbi.nlm.nih.gov]
Right Flank Pain
  • She presented with a two day history of right flank pain that was treated initially as a renal stone. Further investigations confirmed her as a case of renal infarction.[ncbi.nlm.nih.gov]
Neck Swelling
  • This is the story of a boy of 18 years who had got admitted in the department of Otolaryngology, Mymensingh Medical College Hospital with the complaints of a neck swelling, abdominal discomfort, inability to walk, frequency of micturation for almost same[ncbi.nlm.nih.gov]
Hematuria
  • Abstract In the context of increasing flank pain, hematuria, lack of toxicity, and absence of a stone on imaging studies, the cause may be a urinary tract infection due to Staphylococcus saprophyticus.[ncbi.nlm.nih.gov]
  • In 1979, he was admitted to our hospital complaining of hematuria, and died from renal pelvic cancer on the 49th hospital day. Milk of calcium renal stone associated with hydronephrotic kidney is rare, with only 13 cases were reported previously.[ncbi.nlm.nih.gov]
  • The renal stone disappeared 5 days after conservative treatment; the patient's microscopic hematuria resolved concurrently.[ncbi.nlm.nih.gov]
  • RESULTS: Ultrasonography assessment revealed complete stone removal or disposal without hydronephrosis with a significant pain alleviation and significant reduction in ureter bleeding or hematuria along with a little burning sensation in the genital region[ncbi.nlm.nih.gov]
  • […] stones in the Bladder : KI-3, REN-2, REN-3, SP-6, SP-9 REN-3, REN-4, REN-5, SP-6, SP-9, UB-23, UB-28 REN-3, REN-4, ST-36, UB-23, UB-28 Electro-acupuncture SP-6 - UB-23 For stones in the Ureter : SP-6, ST-28, UB-23 REN-6, SP-9, ST-27, ST-28 or ST-25 For hematuria[americandragon.com]
Flank Pain
  • Abstract In the context of increasing flank pain, hematuria, lack of toxicity, and absence of a stone on imaging studies, the cause may be a urinary tract infection due to Staphylococcus saprophyticus.[ncbi.nlm.nih.gov]
  • She presented with a two day history of right flank pain that was treated initially as a renal stone. Further investigations confirmed her as a case of renal infarction.[ncbi.nlm.nih.gov]
  • A Specific Example As an example, I recently met a patient who had been referred from several hours away seeking a fourth opinion regarding her chronic flank pain.[kidneystones.uchicago.edu]
  • This will result in flank pain that extends all the way down to the groin and also radiates to the lower back and groin.[healthhype.com]
  • Snapshot A 30-year-old man presents to the emergency department with severe, colicky left flank pain of acute onset that radiates to the left groin. He also reports urinary frequency and urgency.[medbullets.com]
Decreased Renal Function
  • renal function of the elderly have to be considered.[ncbi.nlm.nih.gov]
  • renal function among adults with a history of nephrolithiasis: a study of NHANES III , Kidney Int , 2005 , vol. 67 (pg. 685 - 690 ) 12 Risk factors for CKD in persons with kidney stones: a case–control study in Olmsted County, Minnesota , Am J Kidney[academic.oup.com]

Workup

  • In all cases it is first imperative to rule out other potential sources of pain; however, such workups often end with the same result – a patient with bothersome flank pain and evidence of one or more nonobstructing stones on imaging.[kidneystones.uchicago.edu]
  • Preoperative workup with contrast-enhanced CT scan with CT angiography for the detailed anatomical and functional status is necessary before proceeding to surgery. Financial support and sponsorship Nil.[urologyannals.com]
  • If more than 50% of the plaque is surrounded by parenchyma, this is a normal variant of renal anatomy and no intervention or further workup is required.[tau.amegroups.com]
  • Trauma Renal calculi Renal cancer Bladder stone or cancer Acute glomerulonephritis Imaging workup of renal cancer and trauma is discussed elsewhere.[meddean.luc.edu]
Increased Bone Density
  • The ingestion of potassium citrate has been associated with increased bone density as well as the prevention of bone loss by providing an alkali load averting the bone resorbing effect of sodium chloride excess.[en.wikipedia.org]
Uric Acid Decreased
  • Despite an increase in urine calcium concentration, the relative saturation of calcium oxalate decreased due to citrate chelation of calcium and the concentration of undissociated uric acid decreased due to the significant increase in urine pH.[ncbi.nlm.nih.gov]
Dyslipidemia
  • Both renal stone disease and gallstone disease are associated with a variety of diseases including obesity, metabolic syndrome, dyslipidemia, hypertension, insulin resistance diabetes and gout.[ncbi.nlm.nih.gov]
Staphylococcus Aureus
  • Positive PMUC demonstrated multidrug-susceptible Escherichia coli and Staphylococcus aureus, while RPUC showed multidrug-resistant pathogens and/or fungus. Seven patients (5.7%) developed postoperative infectious complications prior to discharge.[ncbi.nlm.nih.gov]

Treatment

  • Thus, PCNL is a safe and efficacious treatment for renal stones in patients of all sizes. 2017 S. Karger AG, Basel.[ncbi.nlm.nih.gov]
  • OBJECTIVES: To evaluate by a prospective randomized controlled study the efficacy of the association of potassium citrate and dry extract of couch grass (Agropyrum repens) (CalcoMEV) in renal stone treatment.[ncbi.nlm.nih.gov]
  • A large proportion of subcutaneous fat, which can be estimated by physical examination, predicts SSD among obese patients and may aid treatment decisions in patients, particularly those without pre-treatment CT scans.[ncbi.nlm.nih.gov]
  • OBJECTIVE: To compare outcomes of ureteric and renal stone treatment with ureteroscopy (URS) in patients with or without the placement of a preoperative JJ stent.[ncbi.nlm.nih.gov]
  • Baseline characteristics, stone location, treatment details, postoperative outcomes and complications were recorded.[ncbi.nlm.nih.gov]

Prognosis

  • Although dRTA generally coincides with a more severe nephrocalcinosis than in Dent's disease, patients with the former have a better prognosis in terms of renal function: ESRD reportedly occurred in only 3% of patients during a follow-up of 12 years,[academic.oup.com]
  • ., hypercalciuria and low urine volume forms calcium cystals Prognosis small stones are more likely to spontaneously pass Presentation Symptoms colicky flank pain pain may radiate to the groin or lower abdomen dysuria urgency and frequency Physical exam[medbullets.com]

Etiology

  • There is a substantial number of first or mildly recurrent stone formers who do not undergo any work-up to investigate stone etiology and in whom stone etiology is unknown.[ncbi.nlm.nih.gov]
  • Several aspects unique to renal physiology support this vascular hypothesis as an etiology for Randall plaque formation.[tau.amegroups.com]
  • This can be helpful in patients presenting with non-specific symptoms, where the pre-test probability of a non-stone related etiology is high.[2minutemedicine.com]
  • Renal stones type pH of the urine Etiology Calcium oxalate Variable but mostly in acidic Milk-alkali syndrome, Concentrated urine, Hypercalciuria (vitamin D intoxication, sarcoidosis, hyperparathyroidism) Osteoporosis, Renal tubular acidosis, hyperoxaluria[labpedia.net]
  • Therefore, we are not able to provide data on crystalluria and morphologic analysis which has been shown to be of interest for the etiologic diagnosis of stone disease without available stone.[bmcnephrol.biomedcentral.com]

Epidemiology

  • Interestingly, epidemiologic studies have shown that the incident stone risk increases with body mass index (BMI), and no further increase in risk is noticed when the BMI 30 kg/m(2).[ncbi.nlm.nih.gov]
  • We set up a dedicated renal stone service for children combining medical and surgical expertise in 1993 and now have a large case series of children to investigate the epidemiology.[ncbi.nlm.nih.gov]
  • Most epidemiologic studies of symptomatic urolithiasis in adults also show a male preponderance [ 29, 30 ].[bmcnephrol.biomedcentral.com]
  • Epidemiology More common in men Occur in about 1/1000 individuals By Age 70, 12% of men and 5% of women will have been affected More common in elderly age groups – as they take years to form Aetiology Is generally multifactorial.[almostadoctor.co.uk]
  • , Pediatr Nephrol , 2008 , vol. 23 (pg. 503 - 506 ) 5 Late diagnosis of primary hyperoxaluria after failed kidney transplantation , Int Urol Nephrol , 2010 , vol. 42 (pg. 825 - 829 ) 6 Epidemiology of primary hyperoxaluria type 1.[academic.oup.com]
Sex distribution
Age distribution

Pathophysiology

  • Further research is urgently needed to address the pathophysiology and management of obesity-induced renal stones disease.[ncbi.nlm.nih.gov]
  • PAK Major progress has been made in the pathophysiologic elucidation and management of nephrolithiasis during the past two decades.[books.google.com]
  • Investigation of the aetiology of renal stones is based on urine chemistry rather than analysis of the stone itself because the accuracy of stone analysis is generally poor and, even when accurate, does not explain the pathophysiology of stone formation[pathology.leedsth.nhs.uk]
  • Google Scholar 2 : Pathophysiology of nonhypercalciuric causes of stones.. In: Renal Stone Disease.. Edited by. Boston : Martinus Nijhoff Publishing 1987 : 47. chapt. 3. Google Scholar 3 : Biochemical investigations in renal stone formers.. Ann.[doi.org]
  • The pathophysiologic basis for this treatment is that alpha antagonists inhibit contraction of ureteral muscles responsible for ureterospasm allowing for an increased rate of stone propagation.[rebelem.com]

Prevention

  • KEYWORDS: allopurinol; citrate; prevention; recurrence; renal stone; thiazides[ncbi.nlm.nih.gov]
  • Various substances in the body have an effect on one or more of the above stone-forming processes, thereby influencing a person's ability to promote or prevent stone formation. Promoters facilitate the stone formation while inhibitors prevent it.[ncbi.nlm.nih.gov]
  • A low-normal protein intake decrease calciuria and could be useful in stone prevention and preservation of bone mass.[ncbi.nlm.nih.gov]
  • Besides, metformin markedly prevented the increased concentration of MDA and the decreased tendency of SOD in oxalate-induced MDCK cells and HK-2 cells.[ncbi.nlm.nih.gov]
  • Therapy to prevent stones rests in lowering supersaturation uses both diet and medication. Environmental factors, especially diet, play an important role in the expression of the tendency to stone formation.[ncbi.nlm.nih.gov]

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