urinary calculus (stone, nephrolithiasis, urolithiasis)

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Introduction

Concretions of crystals in the urine, more commonly stones.

Etiology

* calcium stones comprise 75-80% of all stones[3][20]

Epidemiology

  • 13% of men & 7% of women will develop urinary calculi at some point in their lives[20]
  • annual incidence is 0.1%
  • men have twice the risk as females
  • if untreated 50-75% will have recurrence within 7 years
    • 35% to 50% with 5 years[20]

Genetics

Clinical manifestations

Laboratory

* choices of NEJM[44]

Radiology

Complications

Differential diagnosis

Management

* thiazide diuretic, citrate, or allopurinol recommended if adequate fluid intake is not feasible[20]

* urine alkalinization preferable to allopurinol for uric acid stones unless 24 hour urine uric acid > 1000 mg/day[3]

More general terms

More specific terms

Additional terms

References

  1. 1.0 1.1 Saunders Manual of Medical Practice, Rakel (ed), WB Saunders, Philadelphia, 1996, pg 533-34
  2. Mayo Internal Medicine Board Review, 1998-99, Prakash UBS (ed) Lippincott-Raven, Philadelphia, 1998, pg 614-16
  3. 3.00 3.01 3.02 3.03 3.04 3.05 3.06 3.07 3.08 3.09 3.10 3.11 3.12 3.13 3.14 Medical Knowledge Self Assessment Program (MKSAP) 11, 14, 15, 16, 17, 18, 19. American College of Physicians, Philadelphia 1998, 2006, 2009, 2012, 2015, 2018, 2021
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  5. 5.0 5.1 Journal Watch 24(16):125, 2004 Holdgate A, Pollock T. Systematic review of the relative efficacy of non-steroidal anti-inflammatory drugs and opioids in the treatment of acute renal colic. BMJ. 2004 Jun 12;328(7453):1401. Epub 2004 Jun 03. Review. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/15178585 <Internet> http://bmj.bmjjournals.com/cgi/content/full/328/7453/1401
  6. 6.0 6.1 Prescriber's Letter 11(9): 2004 Use of Nifedipine or Tamsulosin for Kidney Stones Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=200911&pb=PRL (subscription needed) http://www.prescribersletter.com
  7. 7.0 7.1 Journal Watch 25(17):135, 2005 Dellabella M, Milanese G, Muzzonigro G. Randomized trial of the efficacy of tamsulosin, nifedipine and phloroglucinol in medical expulsive therapy for distal ureteral calculi. J Urol. 2005 Jul;174(1):167-72. PMID: https://www.ncbi.nlm.nih.gov/pubmed/15947613
  8. 8.0 8.1 Robinson MR et al. Impact of long-term potassium citrate therapy on urinary profiles and recurrent stone formation. J Urol 2009 Mar; 181:1145. PMID: https://www.ncbi.nlm.nih.gov/pubmed/19152932
  9. 9.0 9.1 Moesbergen TC et al. Distal ureteral calculi: US follow-up. Radiology 2011 Aug; 260:575. PMID: https://www.ncbi.nlm.nih.gov/pubmed/21555351
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    Nephrolithiasis Testing Algorithm https://arupconsult.com/algorithm/nephrolithiasis-testing-algorithm
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  22. WebMD: Potassium Citrate for Kidney Stones http://www.webmd.com/kidney-stones/potassium-citrate-for-kidney-stones
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  24. 24.0 24.1 Prescriber's Letter 22(8): 2015 (subscription needed) Medical Expulsive Therapy for Kidney Stones: Does it Help? Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=310805&pb=PRL http://www.prescribersletter.com
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Patient information

urinary calculus patient information