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Chapter: Pathology: Renal Pathology

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Urolithiasis

Urolithiasis
Renal calculi occur in up to 6% of the population; men are affected more often than women.

UROLITHIASIS

 

Renal calculi occur in up to 6% of the population; men are affected more often than women.

 

         Stone composition. Most (75%) stones are calcium oxalate stones. Magne-sium ammonium phosphate (“struvite”) stones are associated with infection by urea-splitting bacteria (proteus), and these stones often form large staghorn calculi. Uric acid stones are seen in gout, leukemia, and in patients with acidic urine. Cystine stones are uncommon.


         Pathology. Most stones are unilateral stones that are formed in the calyx, pelvis, and urinary bladder.

 

         Clinical features. Calcium stones are radiopaque and can be seen on x-ray. Renal colic may occur if small stones pass into the ureters. Stones may cause hematuria, urinary obstruction, and predispose to infection.

 

         Treatment of stones is with lithotripsy or endoscopic removal.

 

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