The most painful of the urologic disorders. These are also called renal calculi they may be formed in any portion of urinary tract-from kidney tubules to external opening.
Calculi typically form in the kidneys and if ideally leave the body via the urethra without pain. Larger stones are painful and ay need surgical intervention. This activity review the evaluation and treatment of kidney stone and the role of the healthcare team in managing patients with this condition.
These are solid crystals that form from dissolved minerals in urines, can be caused by both environmental and metabolic problems. Calcium oxalate stones accounts for almost 70% of all renal stones observed in economically developed countries. Include ric acid, struvite (magnesium ammonium phosphate), and cystine stones.
Kidney stones are quite common and usually affect people who are between 30 and 60 years of age. They affect men more than women. It is found that renal colic (several pain ) affects about 10-20% of men, and 3-5% of women.
The study revealed a high prevalence of kidney stone is due to low fluid intake, dehydration and dietary habits of mixed diet, high intake of coffee and tea, sodium, sugar,
Life style modifications of smoking, alcohol consumption, lack of physical activity, obesity also revealed a high prevalence of this disease.
Depending on composition they are classified into:
*CALCIUM STONES:
>Calcium oxalate stones are envelope or dumbbell-shaped.
>Usually are calcium oxalate stones or calcium phosphate ones.
>Calcium oxalate is the primary component of the majority of stones.
>They typically occur in the setting hypercalciuria, hyperoxaluria, hypomagnesuria, hhypocitrat uria.
>Calcium phosphate are amorphous, wedge-shaped prism in rosette.
*STRUVITE STONES:
>These are formed in response to bacterial infection caused by urea splitting bacteria. These grow quickly and become quite large.
>Magnesium ammonium phosphate: coffin lid shaped also known as struvite stones, seen in infectious stones.In the setting of infections with bacteria that produce urease, such as Proteus mirabilis, Klebsiella pneumonia, Enterobacter, and Pseudomonas aeruginosa.
>The urease produces ammonia and CO2, which creates basic pH urine(>7).
*URIC ACID STONES:
>Uric acid stones are rhomboid shaped.
>In people who don't drink enough water or consume high protein diet can suffer from this type of stones.
>These stones are typically idiopathic. They occur in patients whose diets are high in protein, which acidigies urines pH(>7), allow for uric acid stone formation.
*CYSTINE STONES:
>It is a genetic disorder that causes kidney to excrete too much of certain amino acid.
>These stones are in hexagon shaped.
>These stones are caused by a genetic defect in the transport of the amino acid cystine, resulting in hypercystinuria.
*DRUG-INDUCED STONES:
>This accounts for about 1%of all stone types. Drugs such as triamterene, atazanavir, and sulfa drugs induce theses stones.
>Fr instance, people who take protease inhibitor indinavir sulphate, a drug used to treat HIV infection, are at rusk of developing kidney stones.
>Such a lithogenic drugs or its metabolites may deposit to form a nidus or on renal calculi already present.
>On the other hand, these drugs may induce the formation of calculi thorough its metabolic action by interfering with calcium oxalate or purine metabolisms.
*SYMPTOMS:
*DIAGNOSIS:
>Uric acid content of blood
>Colour of urine
>Kidney X-ray
>Sonography of kidney are different diagnostic tests prescribed depending on symptoms.
