1. Kidney stones form when substances in urine like calcium, oxalate, and uric acid become supersaturated and crystals form. These crystals can grow into stones over time.
2. Kidney stones are common, affecting about 1 in 11 people in the US, and cause pain, bloody or cloudy urine, and nausea.
3. Treatment involves pain medications, increasing fluid intake, and sometimes surgery to remove larger stones. Making dietary changes can help prevent future stone formation.
1. Kidney stones form when substances in urine like calcium, oxalate, and uric acid become supersaturated and crystals form. These crystals can grow into stones over time.
2. Kidney stones are common, affecting about 1 in 11 people in the US, and cause pain, bloody or cloudy urine, and nausea.
3. Treatment involves pain medications, increasing fluid intake, and sometimes surgery to remove larger stones. Making dietary changes can help prevent future stone formation.
1. Kidney stones form when substances in urine like calcium, oxalate, and uric acid become supersaturated and crystals form. These crystals can grow into stones over time.
2. Kidney stones are common, affecting about 1 in 11 people in the US, and cause pain, bloody or cloudy urine, and nausea.
3. Treatment involves pain medications, increasing fluid intake, and sometimes surgery to remove larger stones. Making dietary changes can help prevent future stone formation.
1. Kidney stones form when substances in urine like calcium, oxalate, and uric acid become supersaturated and crystals form. These crystals can grow into stones over time.
2. Kidney stones are common, affecting about 1 in 11 people in the US, and cause pain, bloody or cloudy urine, and nausea.
3. Treatment involves pain medications, increasing fluid intake, and sometimes surgery to remove larger stones. Making dietary changes can help prevent future stone formation.
Download as TXT, PDF, TXT or read online from Scribd
Download as txt, pdf, or txt
You are on page 1/ 3
RENAL CALCULI
Introduction: Renal calculi also known as kidney stone are common condition that can cause severe pain. They can be caused by various factors such as dehydration, certain medications such as diuretics and calcium containing anti acid and some medical conditions like gout, hyper Parathyrodism and Cystinuria. Definition: Renal calculi refers to a small, hard deposit of minerals and acid salt that stick together in a concentrated urine. They can be painful when passing through the urinary tract, but usually don't cause permanent damage. Causes 1-Bone disorders 2-chroic diarrhoea, malabsorption 3-family history of kidney stones 4-GIT disease 5-GI bypass surgery 6-medical conditions e. g gout Risk factors includs: -old age -Not drinking enough water -High blood pressure -supplements such as vitamin D and calcium. Incidence: -Kidney stones are actually quite commo. In United States, it's estimated than 1 in every 11 people will develop a kidney stone at some point of their life. -Kidney stones are more common in men than in women and they are most common in people between ages 30-60yrs. Kidney stones is also higher in ethnic groups such as. pathophysiology: Most urinary stones start as Randall's plaque at the junction of the nephron's collecting tubule and the renal pelvis in the papilla. These plaques start suburothelial and then gradually grow until they break through the urothelium into the renal pelvis. They form an anchored lithogenic nidus for stone formation. Once in continuous contact with urine, layers of calcium oxalate typically start to form on the calcium phosphate nidus (all Randall's plaques are composed of calcium phosphate). Calcium oxalate stones tend to form when the urinary pH is under 7.2, while calcium phosphate will form in more alkaline urine.
Hyperparathyroidism and similar metabolic disturbances like renal tubular acidosis
typically form stones primarily or significantly composed of calcium phosphate. Overly acidic urine is the primary cause of uric acid stones (not hyperuricosuria).
Most renal calculi are made of calcium, followed by urate crystals. Supersaturation of the urine is the common denominator in all cases of renal calculi. In some cases, calcium oxalate stones may deposit in the renal papilla. Calcium phosphate stones usually precipitate in the basement membrane of the thin loop of Henle and may erode into the interstitium. The colicky pain s usually due to the dilatation and spasm of the ureter. In Summary:kidney stones occur in three stages 1. Supersaturation: Urine becomes supersaturated with substances like calcium, oxalate, uric acid, or cystine due to imbalance in excretion and absorption. 2. Nucleation: Crystals start to form in the urine when the concentration of stone- forming substances exceeds the solubility limit. 3. Aggregation: Crystals adhere to each other and accumulate to form small particles that grow in to a larger stone over time. Sign and symptoms: common sign and symptoms include -Pain in the flank, groin or Lower abdomen -Bloody or cloudy urination -Nausea and vomiting -Difficulty urination,fever and chills due to the presence of infection Medical management:
pharmacological management include
1-Medications -Alpha blockers:e.g tamsolusin help relax the muscles of the ureters and bladder which can help the stone to pass more easily. -calcium channel Blockers:such as nifedipine help reduce the amount of calcium in the urine -NSAIDS such as ibuprofen help reduce inflammation and pain. 2-Shock away surgery:sometimes surgery may be needed to remove larger stones. Non-pharmacological management There are a few non-pharmacological measures that can help in the management of kidney stones. -increasing fluid intake to help dilute the urine and reduce the risk of stone formation -making dietary changes to reduce the amount of calcium and oxalate in the diet -Avoiding excessive intake of sodium and animal protein can also help. Additional measure include weight loss and exercise.
Nursing management: -Nurses should educate patients about the importance of drinking plenty of fluids and making dietary changes to prevent the formation of kidney stones. - Nurses should also monitor for signs and symptoms of urinary retention, which can occur if a stone is obstructing the urinary tract. -If urinary retention occurs, nurses should take measures to empty the bladder and relieve the obstruction. -Nurses should also assess the patient's pain level and provide pain management as needed.
Prevention -increase fluid intake to about 1-3 liters per day -Eating a balanced diet, and avoiding excessive intake of sodium, animal protein, and oxalate-rich foods -Taking certain medications to prevent kidney stones. For example, people with hypercalciuria may need to take calcium-binding resins or other medications to reduce the amount of calcium in their urine. -eating and drinking calcium foods such as Youghout and some cheese oxalate rich foods together during eating.
complications -Abscess -Urosepsis -Ureteral scarring or perforation -Urine extravasation -Kidney atrophy in chronic cases\ -Renal failure.
Rehabilitation: After treatment for renal calculus, rehabilitation is often needed to help the patient recover and prevent the recurrence of stone. This may include - Dietary counseling, exercise therapy, and psychological support - patients may need to make lifestyle changes to reduce their risk of future stones. This may include changes to their diet, fluid intake, and activity level.
Reference:Jansonius A, Wiltink J, van der Windt F. Extracorporeal shock wave
lithotripsy under intravenous sedation for treatment of urolithiasis. Scand J Urol. 2018 Oct-Dec;52(5-6):453-458. [PubMed Cohen AJ, Borofsky MS, Anderson BB, Dauw CA, Gillen DL, Gerber GS, Worcester EM, Coe FL, Lingeman JE. Endoscopic Evidence That Randall's Plaque is Associated with Surface Erosion of the Renal Papilla. J Endourol. 2017 Jan;31(1):85-90. [PMC free article] [PubMed
A Study To Assess The Effectiveness of Abdominal Breathing Exercise in Reduction of Blood Pressure Among Hypertensive Patients in Selected Hospitals at Bhopal
