45. Nephrolithiasis


I. Definition

A. Condition in which one or more stones are present in the pelvis or calyces of the kidney or in the ureter

B. Calculi may be composed of calcium oxalate, calcium phosphate, uric acid, struvite, or cystine.

II. Etiology

A. Approximately 10% of the population will develop urinary calculi during their lifetime.

1. More common in men

2. Usual age of onset is in the 30s.

3. Approximately 50% of patients will have a recurrence within 10 years.

B. Dehydration: occurs more frequently in hot, arid environments

C. Life stress

D. Supersaturation of urine with stone-forming salts

1. Overexcretion of salt or reduced urine excretion

2. May occur as a result of dietary overindulgence

E. Decreased stone inhibitors in urine (e.g., citrate, magnesium, pyrophosphate)

IV. Types

A. Calcium stones constitute 80% of renal calculi.

B. Hypercalciuric calcium nephrolithiasis

1. Can be caused by absorptive, reabsorptive, and renal disorders

3. Resorptive

a. Because of hyperparathyroidism

b. Hypercalcemia, hypophosphatemia, and elevated levels of parathyroid hormones are present.

c. Surgical resection of the adenoma, which leads to hyperparathyroidism, cures the disease and the stones.

4. Renal hypercalciuria

a. Renal tubules are unable to reabsorb filtered calcium efficiently, and hypercalciuria occurs.

b. Hydrochlorothiazides (HCTZs) are effective as long-term therapy.

Mar 3, 2017 | Posted by in NURSING | Comments Off on 45. Nephrolithiasis

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