Kidney stones typically form when minerals in urine crystallize and accumulate in the kidneys or urinary tract. The document discusses kidney stone incidence, types, causes, risk factors, formation process, clinical manifestations, and treatment/prevention options. Treatment depends on stone size and symptoms, and may include increased fluid intake, pain medication, medical therapy to pass stones, surgery to break up or remove large stones, or lifestyle changes to prevent future stone formation.

2. INDEX
1. INTRODUCTION
2. INCIDENCE
3. STONE FORMATION
4. TYPE OF STONE
5. CLINICAL MANIFESTATIONS
6. CAUSES & RISK FACTOR
7. PATHOLOGY
8. TRETMENT & PREVENTION
9. REFERENCE

3. OBJECTIVE
• Review basic principles of evaluation of the patient with suspected kidney stone event .
• Discuss medical and surgical treatment options for patients with stones.

4.  INTRODUCTION
 DEFINATION:
Kidney stones are small, hard deposits mineral and acid salts on the inner surfaces of
the kidneys.
• It is also known as; 1) renal lithiasis 2) renal calculi 3) nephrolithiasis
• Composition of kidney stones varies but most common one is of calcium oxalate.
• Kidney stones vary in size and ranges from few mm to cm.

5.  INCIDENCE
 Urinary calculi are more common in men than in women.
 80% of stones under 2mm in size.
 90% of stones pass through the urinary system spontaneously.
 highest incidence of kidney stone is 30-40 years of age groups, and incidence declines
after age of 50.

6.  STONE FORMATION
 Crystal Nucleation:
The first step in the formation of kidney stone begins by the formation
of nucleus (termed as nidus) from supersaturated urine retained inside
the kidneys.
 Crystal Growth:
Crystals in urine stick together to form a small hard mass of stone
referred as crystal growth. Stone growth is accomplished through
aggregation of preformed crystals or secondary nucleation of crystal
on the matrix-coated surface.
 Crystal Aggregation:
The process whereby a small hard mass of a crystal in solution sticks
together to form a larger stone is called aggregation.

7. TYPE OF STONES
CALCI
UM,80
%
STRU
VITE,1
2%
URIC
ACID,
7%
CYSTI
NE,1%
COMPOSITIONS
 CALCIUM OXALATE
CALCIUM PHOSPHATE
STRUVITE
URIC ACID
CYSTINE

8. CLINICAL MANIFESTATIONS
 Sever flank pain
 Abdominal pain
 Nausea and Vomiting
 Fatigue
 elevated temperature, BP, and respirations
 Steady pain
 Pain on urination; Pink, red or brown urine
 Hematuria
 Hydronephrosis

9. CAUSES AND RISK FACTORS
Causes:
• The leading cause of kidney stones is a lack of water in the body.
• Stones are more commonly found in individuals who drink less than the recommended eight to ten
glasses of water a day.
• When there is not enough water to dilute the uric acid, a component of urine, the urine becomes more
acidic.
• An excessively acidic environment in urine can lead to the formation of kidney stones.
• Medical conditions such as Crohn's disease, urinary tract infections, renal tubular acidosis,
hyperparathyroidism, medullary sponge kidney, and Dent's disease increase the risk of kidney stones.

10.  RISK FACTORS
• Arthritis (painful joint inflammation)
• Colitis (inflammation of the colon that causes chronic diarrhea, dehydration, and chemical imbalances)
• Crohn's disease (intestinal disorder that causes chronic diarrhea, dehydration, and low citrate)
• Gout (caused by excessive uric acid in the blood) which leads to high urinary uric acid levels
• High blood pressure (hypertension)
• Hyperparathyroidism (excessive parathyroid hormone, which causes calcium loss from bone)
• Medullary sponge kidney (MSK; a congenital kidney defect associated with urinary tract infections, low urinary citrate levels, and increased urinary calcium loss)
• Renal tubular acidosis (inherited condition in which the kidneys are unable to excrete acid)
• Urinary tract infections (UTIs; affect kidney function and chemistry)
• Inherited condition in which the kidneys are unable to excrete acid (renal tubular acidosis)

11. PATHOPHYSIOLOGY
Saturation Supersaturation Nucleation Crystal growth
Aggregation Crystal retention Stone formation

12. TREATMENT AND PREVENTION
Small stones with minimal symptoms:
 Drinking water: Drinking as much as 2 to 3 quarts (1.9 to 2.8 liters) a day may help flush
out your urinary system.
 Pain relievers: Passing a small stone can cause some discomfort. To relieve mild pain,
your doctor may recommend pain relievers such as ibuprofen.
Medical therapy: Your doctor may give you a medication to help pass your kidney stone.
This type of medication, known as an alpha blocker, relaxes the muscles in your ureter,
helping you pass the kidney stone more quickly and with less pain.

13.  LARGE STONES AND THOSE THAT CAUSE SYMPTOMS:
 Using sound waves to break up stones.
 Surgery to remove very large stones in the kidney
 Using a scope to remove stones
 Parathyroid gland surgery.
Prevention:
• Prevention of kidney stones may include a combination of lifestyle changes and medications.

14. REFERENCE
• https://www.cecentral.com
• https://www.mayoclinic.org
• https://www.medicinenet.com
• https://www.medicalnewstoday.com
• Article about kidney stone causes & risk factors by Stephen Leslie, M.D, swierzwski
1998