Renal Stones (Nephrolithiasis)

Renal Stones (Nephrolithiasis) *

·        Symptoms: 

o   Loin pain Þ stone in kidney

o   Colic anywhere from loin to groin (may just be the tip of the penis) Þ stone in ureter

o   UTI, haematuria, obstruction

·        Risk factors:

o   Low urine output (® drink lots) 

o   Hypercalcaemia: hyperparathyroidism, sarcoid, neoplasia, Addison‟s, Cushing‟s, hyperthyroidism,

o   Li, could be just due to ­Vitamin D in summer

o   Hyperoxaluria: high levels of oxalate in chocolate, tea, rhubarb, spinach

o   Hypocitraturia

o   Hyperuricosuria

·        Investigations:

o   MSU: RBC, UTI, protein, pH (stones like acid urine) 

o  Plain X-ray of kidneys, ureters and bladder

o  Blood: U&Es, urate, Ca, PO4, HCO₃

·        Management: 

o  Pain relief: NSAIDS (but care with ¯renal flow) or morphine

o  ­Fluid intake

o  Sieve urine to catch the stone for analysis 

o  If obstruction or infection ® urgent urologist referral