Nephrolithiasis (Renal Calculi)
SX â renal colic, CVA pain, hematuria, N/V.
PE â
⢠Flank, GU, abd, groin.
Next Steps
DX â CBC, CMP, PTH, U/A w/ Cx. 24 hr urine (Ca, Cr,
uric acid, oxalate, cystine, citrate, Na, Mg, struvite stones/proteus). ⢠Imaging: CT scan, KUB, Renal Ultrasound. ⢠Stone analysis (stone composition).
Health Tips
TX â Most likely in-patient treatment. ⢠Pain control (Tyl # 3), IV Ketorolac, Tramadol. ⢠Hydration: 2-3 L / day, IVF - to help pass stones less than 4mm. ⢠Lithotripsy, for stones between 4mm and 2cm. Maintenance, based on stone composition: ⢠Ca stones â HCTZ. â¢
Uric acid â K citrate. ⢠Cystine stones â K citrate. Struvite stones â acetohydrozamic acid (lithostat). For ALL: adequate hydration, at least 2 liters per day.