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Renal calculi /Stone/Nephrolithiasis
By-
Mr. ASHOK DHAKA BISHNOI
Director, JINC
 A kidney stone is a hard solid mass of
material that forms in the kidney from the
substances in the urine.
 Kidney stones or calculi develop as a result of
various metabloic disorders which affect the
fate of calcium and other mineral elements in
the body.
 Stones may be formed in the kidney, urinary
bladder,ureter and urethra
Introduction:-
 A kidney stone, also known as a renal
calculus or nephrolith, is a solid piece of
material which is formed in the kidneys from
minerals in urine
Meaning:-
Incidence:-
 Unknown
 Risk factor:-
 Imbalance of pH in urine
◦ Alkalic:-Calcium stone
◦ Acidic:-Uric & cristine stone
 Gout
 Hyperparathyroidism
Etiology:-
There are mainly 5 types:-
1. Calcium oxalate stone (Is the most common 80% )
2. Calcium phosphate stone
3. Struvite stone (Triple stone)
4. Uric acid stone
5. Cystic stone
Type of renal stone:-
1.Calcium oxalate stone (Is the most common 80% )-
Caused by super -saturation of urine with calcium & oxalate
Calcium oxalate stone tend to form in alkaline chemistry
( Avoid food high in oxalate(beer, wheat germ, spinach)
2. Calcium phosphate stone (5-10%):- Caused by
super -saturation of urine with calcium phasphate.
Calcium phosphpate stone tend to form in alkaline chemistry
(Avoid food high in calcium (Milk & dairy product)
3. Struvite stone (Triple phosphate stone):-
Caused by urea splitting bacteria (Proteus, Pseudomonas, Klebsiella,
Staphylococcus) –more common women then the man because of UTI
Struvite stone stone tend to form in alkaline chemistry
4. Cystic stone (10-15%):- Caused by cystine crystal
formation
Cystic stone stone tend to form in Acidic urine
( cystine source Avoid meat milk ,cheese, Egg)
5. Uric acid stone (5-10%):-Caused by excessive
dietary purine or gout
Uric acid stone tend to form in Acidic urine
(Avoid purine sources eg. Meats, gravies, red wine)
Urine saturation
Supersaturation
Crystal nucleation
Aggregation
Retention and growth
 Severe pain in the side and back, below the
ribs
 Pain that spreads to the lower abdomen and
groin
 Pain that comes in waves and fluctuates in
intensity
 Pain on urination
 Cloudy or foul-smelling urine
 Nausea and vomiting
 Fever and chills if an infection is present
 Urinating small amounts of urine
Clinical manifestation:-
 Blood
 Urine-analysis
 Cystoscopy
 X-ray
 CT scan, MRI
 Intravenous urogram (IVU) or intravenous
pyelogram
 USG
 KUB
Diagnostic evaluation:-
Medical management:-
 Analgesic
 Spasmotic eg Buscopan
 NSAIDs eg Steroid
 Maintain I/O charting
 Provide rest
Management:-
 Close procedure:-
 Lithotripsy (Extracorporeal Shockwave lithotripsy (ESWL)-
Noninvasive
Surgical management:-
Open procedure:-
 Ureterolithotomy
 Pyelolithotomy
 Nephrolithotomy
 Partial or total nephrectomy
 Report increased redness in urine
 Monitor vital signs
 Fluid balance chart
 Observation for anuria
 Observation for signs of infection.
Nurses role:-

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Renal calculi

  • 1. Renal calculi /Stone/Nephrolithiasis By- Mr. ASHOK DHAKA BISHNOI Director, JINC
  • 2.  A kidney stone is a hard solid mass of material that forms in the kidney from the substances in the urine.  Kidney stones or calculi develop as a result of various metabloic disorders which affect the fate of calcium and other mineral elements in the body.  Stones may be formed in the kidney, urinary bladder,ureter and urethra Introduction:-
  • 3.  A kidney stone, also known as a renal calculus or nephrolith, is a solid piece of material which is formed in the kidneys from minerals in urine Meaning:-
  • 5.  Unknown  Risk factor:-  Imbalance of pH in urine ◦ Alkalic:-Calcium stone ◦ Acidic:-Uric & cristine stone  Gout  Hyperparathyroidism Etiology:-
  • 6. There are mainly 5 types:- 1. Calcium oxalate stone (Is the most common 80% ) 2. Calcium phosphate stone 3. Struvite stone (Triple stone) 4. Uric acid stone 5. Cystic stone Type of renal stone:-
  • 7. 1.Calcium oxalate stone (Is the most common 80% )- Caused by super -saturation of urine with calcium & oxalate Calcium oxalate stone tend to form in alkaline chemistry ( Avoid food high in oxalate(beer, wheat germ, spinach) 2. Calcium phosphate stone (5-10%):- Caused by super -saturation of urine with calcium phasphate. Calcium phosphpate stone tend to form in alkaline chemistry (Avoid food high in calcium (Milk & dairy product) 3. Struvite stone (Triple phosphate stone):- Caused by urea splitting bacteria (Proteus, Pseudomonas, Klebsiella, Staphylococcus) –more common women then the man because of UTI Struvite stone stone tend to form in alkaline chemistry
  • 8. 4. Cystic stone (10-15%):- Caused by cystine crystal formation Cystic stone stone tend to form in Acidic urine ( cystine source Avoid meat milk ,cheese, Egg) 5. Uric acid stone (5-10%):-Caused by excessive dietary purine or gout Uric acid stone tend to form in Acidic urine (Avoid purine sources eg. Meats, gravies, red wine)
  • 10.  Severe pain in the side and back, below the ribs  Pain that spreads to the lower abdomen and groin  Pain that comes in waves and fluctuates in intensity  Pain on urination  Cloudy or foul-smelling urine  Nausea and vomiting  Fever and chills if an infection is present  Urinating small amounts of urine Clinical manifestation:-
  • 11.  Blood  Urine-analysis  Cystoscopy  X-ray  CT scan, MRI  Intravenous urogram (IVU) or intravenous pyelogram  USG  KUB Diagnostic evaluation:-
  • 12.
  • 13.
  • 14.
  • 15. Medical management:-  Analgesic  Spasmotic eg Buscopan  NSAIDs eg Steroid  Maintain I/O charting  Provide rest Management:-
  • 16.  Close procedure:-  Lithotripsy (Extracorporeal Shockwave lithotripsy (ESWL)- Noninvasive Surgical management:-
  • 17.
  • 18.
  • 19.
  • 20.
  • 21.
  • 22.
  • 23.
  • 24. Open procedure:-  Ureterolithotomy  Pyelolithotomy  Nephrolithotomy  Partial or total nephrectomy
  • 25.  Report increased redness in urine  Monitor vital signs  Fluid balance chart  Observation for anuria  Observation for signs of infection. Nurses role:-