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UNIVERSIDAD TECNICA DE MACHALA
ACADEMIC UNIT OF CHEMICAL
SCIENCES AND HEALTH
MEDICINE SCHOOL
ENGLISH
NEPHROLITHIASIS
STUDENTS
William Cruz
Kevin Herrera
TEACHER:
Mgs. Barreto Huilcapi Lina Maribel
CLASS:
EIGHTH SEMESTER ‘’A’’
Machala, El Oro
2018

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Nephrolithiasis
Concept.- Renal lithiasis is a complex condition in which genetic, anatomical and
environmental factors intervene. It has been known to be associated with an
increased risk of hypertension, heart disease, metabolic syndrome and diabetes
mellitus.
Epidemiology.- Predominates in the male sex, with a ratio of 2-4: 1, and occurs
mainly during the third decade of life. In women, there is a second peak of incidence
over the fifth decade of life, as a consequence of hypercalciuria induced by an
increase in resorption related to menopause.
Pathogenesis .- are usually the result of the breakage of a delicate balance between
the solubility and theprecipitation of salts and are more likely when there are one or
more factors that lead to the saturation of urine, the formation of crystals and the
consequent aggregation to form the calculoclinically detectable.
Signs and symptons.- it is very variable. If it is fixed in the papilla, it is usually
asymptomatic but may present microscopic or macroscopic hematuria. However,
when the stone moves or falls off and descends through the urinary tract, it
produces acute pain as a consequence of the distension of the urinary tract
(nephritic colic). The pain is first installed in the lumbar fossa and its intensity
increases rapidly until it becomes intolerable. This picture is usually accompanied by
nausea, vomiting, sweating, paleness and sometimes paralytic ileus that may have
microscopic or macroscopic hematuria.
There may also be hypersensitivity in the lumbar area or in the anterior part of the
abdomen, with associated muscular rigidity. Pain may remain in the lumbar fossa or
radiate initially to the abdominal flank and subsequently to the testicular area or
vulva. If the pain migrates downward, it indicates that the calculus goes down the
ureter. The stones in the middle third of the ureter usually produce pain in the flank

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and those in the lower third cause lower abdominal or genital pain. When the stone
is in the intravesical portion of the ureter, it produces urination syndrome or pain in
the genital area. The pain of the colliconephritis usually disappears when the
displacement of the calculus allows the decompression of the urinary tract.
Diagnosis.- It is necessary to confirm the presence of the stones, avoid and / or
detect the associated complications and finally try to identify the specific alteration
that causes the formation of stones to be able to apply a specific treatment. We
need to know the number of stones, frequency of formation, age of onset, size and
kidney affected, type of stone if known, previous need for urological intervention
and response, associated infections, family history, type of diet, medication.
Complementary explorations.- Helical CT, is considered the best image test since it
offers patterns that give orientation to know the composition of the calculation.
Other methods are simple abdominal radiography, urography i.v and abdominal
ultrasound.
Types of lithiasis:
Calcic lithiasis - is the most common cause of kidney stones.
 Hypercalciuria.- When hypercalciuria is present, the presence of
hypercalcemia should be ruled out first, since the most frequent cause of
renal lithiasis associated with hypercalcemia is primary hyperparathyroidism,
responsible for 5% of stones. Other disorders that can cause hypercalcemia
and hypercalciuria are metastasis, multiple myeloma, lymphomas, leukemia,
vitamin D poisoning, sarcoidosis, milk and alkaline syndrome, immobilization,
thyrotoxicosis, Paget's disease and Cushing's syndrome.
 Idiopathic hypercalciuria.- is the most common cause of renal lithiasis,
responsible for 60% of cases of renal lithiasis and 70% -80% of those with

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hypercalciuria. It tends to be familiar, it is more prevalent in envarones than
in women and the first lithiasic episode usually occurs during the third
decade of life. The calculations are composed almost exclusively of calcium
deoxalate, although calcium phosphate can also be part of its composition.
 Hypocitraturia Citrate inhibits the spontaneous nucleation of calcium oxalate
and retards the agglomeration of the preformed crystals of this. In addition,
it is a potent inhibitor of the growth of calcium phosphate crystals and
reduces the urinary saturation of calciumsalts.
• Hyperoxaluria.- The organism does not metabolize oxalate, so it can be eliminated
through renal excretion, and comes from two sources: the endogenous production
and intestinal absorption from food. Hyperoxaluria is defined as the urinary
elimination of oxalate greater than 50 mg / day.
Uric lithiasis
• Hyperuricosuria - urinary uric acid excretion higher than 800 mg / day in men and
750 mg / day in women) should be considered initially the plasma values of uric acid
to distinguish the states in which there is overproduction of uric acid, it is observed

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REFERENCIA BIBLIOGRÁFICA
J.C. Rodríguez Pérez, “Litiasis Renal”,.Medicina interna Farreras V. y Rozman C.
17ava edición. Barcelona España: Elsevier 2012, volumen 1, pag902- 907