{"id":4932,"date":"2025-11-22T18:56:40","date_gmt":"2025-11-22T23:56:40","guid":{"rendered":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/?post_type=chapter&p=4932"},"modified":"2025-12-07T23:14:40","modified_gmt":"2025-12-08T04:14:40","slug":"kidney-stones-urolithiasis-renal-calculi","status":"web-only","type":"chapter","link":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/chapter\/kidney-stones-urolithiasis-renal-calculi\/","title":{"raw":"8p12 Kidney Stones (Urolithiasis, Renal Calculi)","rendered":"8p12 Kidney Stones (Urolithiasis, Renal Calculi)"},"content":{"raw":"Urinary Tract Obstructions \u2013 Kidney Stones (Urolithiasis, Renal Calculi)<\/strong>\r\n

Types & Causes:<\/strong><\/h1>\r\n
    \r\n \t
  • Kidney stones<\/strong>\u00a0(also called\u00a0calculi<\/strong>\u00a0or\u00a0urolithiasis<\/strong>) can develop anywhere along the urinary tract.<\/li>\r\n \t
  • Composed of\u00a0crystallized solutes<\/strong>:\r\n
      \r\n \t
    • Calcium salts:<\/strong>\u00a0most common (~75% calcium oxalate<\/strong>), especially in\u00a0alkaline urine<\/strong>.<\/li>\r\n \t
    • Uric acid:<\/strong>\u00a0linked to hyperuricemia<\/strong>,\u00a0gouty arthritis,<\/strong>\u00a0and high purine<\/strong> diets (e.g., high protein diets).<\/li>\r\n \t
    • Sometimes\u00a0struvite (Mg)<\/strong>\u00a0stones due to UTI.<\/li>\r\n \t
    • Sometimes\u00a0cystine<\/strong>\u00a0stones, due to genetic disorders (creating too much cystine amino acid).<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n

      Risk Factors:<\/strong><\/h1>\r\n
        \r\n \t
      • Dehydration:<\/strong>\u00a0too little fluid intake, abuse of laxatives, concentrates urine, promoting crystallization.<\/li>\r\n \t
      • Infections:<\/strong>\u00a0bacteria can lead to stone formation or incorporate into stones.<\/li>\r\n \t
      • Immobility<\/strong>: due to stasis of urine<\/li>\r\n \t
      • Genetics:<\/strong>\u00a0family history increases susceptibility.<\/li>\r\n \t
      • Diet:<\/strong>\u00a0high salt, protein, or sugar intake. Foods high in oxalates, such as spinach, Swiss chard, and chocolate<\/li>\r\n<\/ul>\r\n
          \r\n \t
        • Hyperparathyroidism<\/strong>: Excessive parathyroid hormone increases calcium release from bones, leading to hypercalcemia, increases risk of calcium-based stones<\/li>\r\n<\/ul>\r\n
            \r\n \t
          • Other factors:<\/strong>\u00a0obesity, metabolic disturbances, or certain metabolic diseases.<\/li>\r\n<\/ul>\r\n

            Formation & Pathology:<\/strong><\/h1>\r\n
              \r\n \t
            • Excess solutes\u00a0crystallize<\/strong>\u00a0and grow, forming stones.<\/li>\r\n \t
            • Stones can\u00a0remain small and asymptomatic<\/strong>\u00a0or\u00a0grow large enough<\/strong> to cause problems.<\/li>\r\n \t
            • Obstruction:\u00a0 <\/strong>Stones lodged in the\u00a0ureter<\/strong>\u00a0block urine flow.<\/li>\r\n<\/ul>\r\n
                \r\n \t
              • <\/li>\r\n<\/ul>\r\nPossible Complication<\/strong>:\r\n
                  \r\n \t
                • \r\n
                    \r\n \t
                  • causes\u00a0hydronephrosis<\/strong>\u2014urine buildup in the kidney, increases\u00a0pressure<\/strong>, compresses blood vessels, reduces\u00a0renal blood flow<\/strong>\u00a0(ischemia), damages nephrons, and causes necrosis and atrophy.<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n

                    Symptoms & Signs:<\/strong><\/h1>\r\n
                      \r\n \t
                    • Small stones:<\/strong>\u00a0Usually silent (asymptomatic) or cause mild irritation.<\/li>\r\n \t
                    • Large stones or obstructing stones:<\/strong>\r\n
                        \r\n \t
                      • Flank pain:<\/strong>\u00a0Due to\u00a0distension<\/strong>\u00a0of the kidney capsule.<\/li>\r\n \t
                      • Renal colic:<\/strong>\u00a0Severe, episodic spasm in flank area radiating towards groin as the stone moves down the ureter.\u00a0 Pain\u00a0flares and subsides<\/strong>\u00a0as the stone is pushed through the ureter.<\/li>\r\n \t
                      • Nausea and vomiting<\/strong>, cool moist skin, rapid pulse<\/li>\r\n \t
                      • Hematuria:<\/strong>\u00a0Blood in urine from ureter or bladder irritation.<\/li>\r\n \t
                      • Infection signs:<\/strong>\u00a0Fever, chills if infection occurs.<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n

                        Diagnosis:<\/strong><\/h1>\r\n
                          \r\n \t
                        • Imaging:\u00a0 X-ray<\/strong>\u00a0or\u00a0CT scan <\/strong>to locate and size stones.<\/li>\r\n \t
                        • Urine analysis:<\/strong>\u00a0Detects crystals, blood, and possible infection.<\/li>\r\n \t
                        • Blood tests:<\/strong>\u00a0Check for calcium, uric acid, and other metabolic contributors.<\/li>\r\n<\/ul>\r\n

                          Treatment:<\/strong><\/h1>\r\n
                            \r\n \t
                          • Small stones:<\/strong>\u00a0Often pass\u00a0spontaneously<\/strong>\u00a0with increased fluid intake and pain management.<\/li>\r\n \t
                          • Moderate to large stones:<\/strong>\r\n
                              \r\n \t
                            • Extracorporeal shockwave lithotripsy (ESWL):<\/strong>\u00a0Non-invasive method using ultrasound shockwaves to break stones so that they can pass on their own.<\/li>\r\n \t
                            • Medications:<\/strong>\r\n
                                \r\n \t
                              • Alpha blockers<\/strong>\u00a0(e.g., tamsulosin) relax ureter muscles and facilitate passage.<\/li>\r\n \t
                              • Medications<\/strong> to dissolve stones partially<\/li>\r\n \t
                              • Painkillers<\/strong>\u00a0for discomfort.<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t
                              • Surgical options:<\/strong>\r\n
                                  \r\n \t
                                • Ureteroscopy:<\/strong>\u00a0Inserted via the urethra to locate and break stones.<\/li>\r\n \t
                                • Laser lithotripsy:<\/strong>\u00a0Use ureteroscope with laser at tip for more precise stone fragmentation (and expandable basket to collect fragments.<\/li>\r\n \t
                                • Percutaneous nephrolithotomy:<\/strong>\u00a0Small incision in back, through the skin into the renal pelvis to remove larger or harder stones through tube.<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n

                                  Prevention:<\/strong><\/h1>\r\n
                                    \r\n \t
                                  • Increase\u00a0fluid intake<\/strong>.<\/li>\r\n \t
                                  • Dietary modifications to reduce calcium<\/strong>, oxalate<\/strong>, or purine<\/strong> levels.<\/li>\r\n \t
                                  • Treat underlying metabolic disorders.<\/li>\r\n \t
                                  • Reduce intake of excess\u00a0calcium<\/strong>\u00a0if hypercalcemia is present, under medical guidance.<\/li>\r\n<\/ul>\r\n

                                    Summary:<\/strong><\/h1>\r\nKidney stones form from crystallized solutes, often related to dehydration, infection, or diet. They may stay silent or cause severe pain and obstruction. Diagnostic imaging guides treatment, which may include medical therapy, lithotripsy, or surgery. Preventive measures involve hydration and dietary management to minimize recurrence risk.","rendered":"

                                    Urinary Tract Obstructions \u2013 Kidney Stones (Urolithiasis, Renal Calculi)<\/strong><\/p>\n

                                    Types & Causes:<\/strong><\/h1>\n
                                      \n
                                    • Kidney stones<\/strong>\u00a0(also called\u00a0calculi<\/strong>\u00a0or\u00a0urolithiasis<\/strong>) can develop anywhere along the urinary tract.<\/li>\n
                                    • Composed of\u00a0crystallized solutes<\/strong>:\n
                                        \n
                                      • Calcium salts:<\/strong>\u00a0most common (~75% calcium oxalate<\/strong>), especially in\u00a0alkaline urine<\/strong>.<\/li>\n
                                      • Uric acid:<\/strong>\u00a0linked to hyperuricemia<\/strong>,\u00a0gouty arthritis,<\/strong>\u00a0and high purine<\/strong> diets (e.g., high protein diets).<\/li>\n
                                      • Sometimes\u00a0struvite (Mg)<\/strong>\u00a0stones due to UTI.<\/li>\n
                                      • Sometimes\u00a0cystine<\/strong>\u00a0stones, due to genetic disorders (creating too much cystine amino acid).<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n

                                        Risk Factors:<\/strong><\/h1>\n
                                          \n
                                        • Dehydration:<\/strong>\u00a0too little fluid intake, abuse of laxatives, concentrates urine, promoting crystallization.<\/li>\n
                                        • Infections:<\/strong>\u00a0bacteria can lead to stone formation or incorporate into stones.<\/li>\n
                                        • Immobility<\/strong>: due to stasis of urine<\/li>\n
                                        • Genetics:<\/strong>\u00a0family history increases susceptibility.<\/li>\n
                                        • Diet:<\/strong>\u00a0high salt, protein, or sugar intake. Foods high in oxalates, such as spinach, Swiss chard, and chocolate<\/li>\n<\/ul>\n
                                            \n
                                          • Hyperparathyroidism<\/strong>: Excessive parathyroid hormone increases calcium release from bones, leading to hypercalcemia, increases risk of calcium-based stones<\/li>\n<\/ul>\n
                                              \n
                                            • Other factors:<\/strong>\u00a0obesity, metabolic disturbances, or certain metabolic diseases.<\/li>\n<\/ul>\n

                                              Formation & Pathology:<\/strong><\/h1>\n
                                                \n
                                              • Excess solutes\u00a0crystallize<\/strong>\u00a0and grow, forming stones.<\/li>\n
                                              • Stones can\u00a0remain small and asymptomatic<\/strong>\u00a0or\u00a0grow large enough<\/strong> to cause problems.<\/li>\n
                                              • Obstruction:\u00a0 <\/strong>Stones lodged in the\u00a0ureter<\/strong>\u00a0block urine flow.<\/li>\n<\/ul>\n
                                                  \n
                                                • <\/li>\n<\/ul>\n

                                                  Possible Complication<\/strong>:<\/p>\n

                                                    \n
                                                  • \n
                                                      \n
                                                    • causes\u00a0hydronephrosis<\/strong>\u2014urine buildup in the kidney, increases\u00a0pressure<\/strong>, compresses blood vessels, reduces\u00a0renal blood flow<\/strong>\u00a0(ischemia), damages nephrons, and causes necrosis and atrophy.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n

                                                      Symptoms & Signs:<\/strong><\/h1>\n
                                                        \n
                                                      • Small stones:<\/strong>\u00a0Usually silent (asymptomatic) or cause mild irritation.<\/li>\n
                                                      • Large stones or obstructing stones:<\/strong>\n
                                                          \n
                                                        • Flank pain:<\/strong>\u00a0Due to\u00a0distension<\/strong>\u00a0of the kidney capsule.<\/li>\n
                                                        • Renal colic:<\/strong>\u00a0Severe, episodic spasm in flank area radiating towards groin as the stone moves down the ureter.\u00a0 Pain\u00a0flares and subsides<\/strong>\u00a0as the stone is pushed through the ureter.<\/li>\n
                                                        • Nausea and vomiting<\/strong>, cool moist skin, rapid pulse<\/li>\n
                                                        • Hematuria:<\/strong>\u00a0Blood in urine from ureter or bladder irritation.<\/li>\n
                                                        • Infection signs:<\/strong>\u00a0Fever, chills if infection occurs.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n

                                                          Diagnosis:<\/strong><\/h1>\n
                                                            \n
                                                          • Imaging:\u00a0 X-ray<\/strong>\u00a0or\u00a0CT scan <\/strong>to locate and size stones.<\/li>\n
                                                          • Urine analysis:<\/strong>\u00a0Detects crystals, blood, and possible infection.<\/li>\n
                                                          • Blood tests:<\/strong>\u00a0Check for calcium, uric acid, and other metabolic contributors.<\/li>\n<\/ul>\n

                                                            Treatment:<\/strong><\/h1>\n
                                                              \n
                                                            • Small stones:<\/strong>\u00a0Often pass\u00a0spontaneously<\/strong>\u00a0with increased fluid intake and pain management.<\/li>\n
                                                            • Moderate to large stones:<\/strong>\n
                                                                \n
                                                              • Extracorporeal shockwave lithotripsy (ESWL):<\/strong>\u00a0Non-invasive method using ultrasound shockwaves to break stones so that they can pass on their own.<\/li>\n
                                                              • Medications:<\/strong>\n
                                                                  \n
                                                                • Alpha blockers<\/strong>\u00a0(e.g., tamsulosin) relax ureter muscles and facilitate passage.<\/li>\n
                                                                • Medications<\/strong> to dissolve stones partially<\/li>\n
                                                                • Painkillers<\/strong>\u00a0for discomfort.<\/li>\n<\/ul>\n<\/li>\n
                                                                • Surgical options:<\/strong>\n
                                                                    \n
                                                                  • Ureteroscopy:<\/strong>\u00a0Inserted via the urethra to locate and break stones.<\/li>\n
                                                                  • Laser lithotripsy:<\/strong>\u00a0Use ureteroscope with laser at tip for more precise stone fragmentation (and expandable basket to collect fragments.<\/li>\n
                                                                  • Percutaneous nephrolithotomy:<\/strong>\u00a0Small incision in back, through the skin into the renal pelvis to remove larger or harder stones through tube.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n

                                                                    Prevention:<\/strong><\/h1>\n
                                                                      \n
                                                                    • Increase\u00a0fluid intake<\/strong>.<\/li>\n
                                                                    • Dietary modifications to reduce calcium<\/strong>, oxalate<\/strong>, or purine<\/strong> levels.<\/li>\n
                                                                    • Treat underlying metabolic disorders.<\/li>\n
                                                                    • Reduce intake of excess\u00a0calcium<\/strong>\u00a0if hypercalcemia is present, under medical guidance.<\/li>\n<\/ul>\n

                                                                      Summary:<\/strong><\/h1>\n

                                                                      Kidney stones form from crystallized solutes, often related to dehydration, infection, or diet. They may stay silent or cause severe pain and obstruction. Diagnostic imaging guides treatment, which may include medical therapy, lithotripsy, or surgery. Preventive measures involve hydration and dietary management to minimize recurrence risk.<\/p>\n","protected":false},"author":1370,"menu_order":15,"template":"","meta":{"pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":["zoe-soon"],"pb_section_license":"cc-by-nc-sa"},"chapter-type":[],"contributor":[60],"license":[57],"class_list":["post-4932","chapter","type-chapter","status-web-only","hentry","contributor-zoe-soon","license-cc-by-nc-sa"],"part":59,"_links":{"self":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapters\/4932","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/wp\/v2\/users\/1370"}],"version-history":[{"count":5,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapters\/4932\/revisions"}],"predecessor-version":[{"id":5273,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapters\/4932\/revisions\/5273"}],"part":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/parts\/59"}],"metadata":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapters\/4932\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/wp\/v2\/media?parent=4932"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapter-type?post=4932"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/wp\/v2\/contributor?post=4932"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/wp\/v2\/license?post=4932"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}