Nephrolithiasis resident survival guide

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Definition

Causes

Life Threatening Causes

  • Renal Obstruction
  • Renal Isquaemia
  • Renal Impairment

Common Causes

  • Hypercalciuria
  • Hyperoxaluria
  • Hypernatruria
  • Hypocitraturia
  • Gout
  • Previous chemotherapy for Lymphoma and Leukemia
  • Increced Cystine
  • Drug related stones (Xantines)

Management

Diagnostic Approach

Shown below is an algorithm depicting the diagnostic approach to Nephrolithiasis based on the 2014 Review of the Cleveland Clinic, urological and kidney institue.[1]

 
 
 
 
 
Characterize the symptoms:[2]

Abdominal Pain

❑ Irradiated to the lower abdomen and groin
❑ Acute pain

Urinary urgency
Dysuria
Polyuria
Vomits
Nausea
Malaise

Fever and chills
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

References

  1. Frassetto L, Kohlstadt I (2011). "Treatment and prevention of kidney stones: an update". Am Fam Physician. 84 (11): 1234–42. PMID 22150656.
  2. Miller NL, Lingeman JE (2007). "Management of kidney stones". BMJ. 334 (7591): 468–72. doi:10.1136/bmj.39113.480185.80. PMC 1808123. PMID 17332586.


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