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

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  2. Mayo Internal Medicine Board Review, 1998-99, Prakash UBS (ed) Lippincott-Raven, Philadelphia, 1998, pg 614-16
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  5. Jump up to: 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. Jump up to: 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
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  8. Jump up to: 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
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    Nephrolithiasis Testing Algorithm https://arupconsult.com/algorithm/nephrolithiasis-testing-algorithm
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  16. Eisner BH, Eisenberg ML, Stoller ML. Relationship between body mass index and quantitative 24-hour urine chemistries in patients with nephrolithiasis. Urology. 2010 Jun;75(6):1289-93 PMID: https://www.ncbi.nlm.nih.gov/pubmed/20018350
  17. Taylor EN, Fung TT, Curhan GC. DASH-style diet associates with reduced risk for kidney stones. J Am Soc Nephrol. 2009 Oct;20(10):2253-9 PMID: https://www.ncbi.nlm.nih.gov/pubmed/19679672
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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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Patient information

urinary calculus patient information