Home
Radiology Guides Anatomy Physio & Path Medicine Physics Contact
RENAL STONES

Nephrology

RENAL STONES

1. Stones - calcium oxalate, calcium phosphate, uric acid, struvite.

2. Investigations:
- Chemical analysis of the stone
- Serum calcium, iPTH (exclude hyperparathyroidism)
- Electrolytes and urine pH (exclude Type 1 distal RTA)
- U/A with C+S (exclude stone-forming urinary pathogens; clue = urine pH> 7.5)
- AXR to detect radio-opaque (calcium, cysteine, struvite) vs. radiolucent (uric) stones
- Renal imaging (helical CT is the gold standard; rarely use IVP; in patients with impaired renal function, begin with ultrasound imaging of the kidney)

3. For recurrent stones, perform 24-hour urine collection for: volume, cystine, calcium, Na, urea, uric acid, citrate, oxalate, and creatinine.


Avatar
REFERENCES

1. Wilkinson, I. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press.
2. Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
3. Image: no reference available.

Ⓒ A. Manickam 2018

+ Home