25/4/2021 Ne h li hia i - S a Pea l - NCBI B k helf

Ne h li hia i
N jaba L G a N

C i i g Ed ca i Ac i i
Neph oli hia i i he e m emplo ed fo kidne one , al o kno n a enal calc li, and he a e c al conc e ion fo med picall in he kidne .
Calc li picall fo m in he kidne and ideall lea e he bod ia he e h a i ho pain. La ge one a e painf l and ma need gical
in e en ion. Thi ac i i e ie he e al a ion and ea men of neph oli hia i and he ole of he heal hca e eam in managing pa ien i h hi
condi ion.

Ob ec i e :

Re ie he i k fac o fo de eloping neph oli hia i .

E plain he common ph ical e am finding a ocia ed i h neph oli hia i .
O line common ea men op ion fo neph oli hia i .
Re ie he impo ance of imp o ing ca e coo dina ion among in e p ofe ional eam membe o enhance he deli e of ca e fo pa ien
affec ed b neph oli hia i .

Ea n con in ing ed ca ion c edi (CME/CE) on hi opic.

I d ci
Neph oli hia i , o kidne one , i he mo common condi ion affec ing he ina em, affec ing abo 12% of he o ld pop la ion, i h a
ea l incidence of 600,000 in Ame ica. I i he e l of a c al o c alline conc e ion a eling f om he kidne h o gh he geni o ina
em.[1][2] Kidne one co ela e i h an inc ea ed i k of ch onic kidne di ea e , end- age enal fail e, ca dio a c la di ea e , diabe e , and
h pe en ion.[3]

Ei l g
Mo pa ien i h neph oli hia i fo m calci m one (80%), mo of hich a e compo ed p ima il of calci m o ala e o calci m pho pha e. The
o he main pe incl de ic acid, i e (magne i m ammoni m pho pha e), and c ine one . Of no e, one pa ien ma ha e a one ha con ain
mo e han one pe of c al.

Ri Fac - Infl enced b ce ain di ea e , habi , compo i ion of ine.

Pe onal hi o of p io kidne one inc ea e he i k of kidne one [4] b 15% i hin he fi ea , and 50% i hin he ne en ea .
A famil hi o of kidne one inc ea e he i k b 2.5 ime .
Inc ea ed en e ic o ala e ab o p ion, picall d e o malab o p ion, lead o inc ea ed fo ma ion of calci m o ala e c al .
U ina ac infec ion al e ing ina pH in he e ing of ea e-p od cing bac e ia, p od cing iec al
Lo fl id in ake [5]
Hi o of diabe e , obe i , go , and h pe en ion [6]
Acidic ine (pH< 5.5), hich p omo e ic acid fo ma ion in he e ing of ch onic dia hea and go

E ide i l g
The p e alence and ec ence a e of neph oli hia i a e inc ea ing, i h limi ed op ion of effec i e d g and p oced e , affec ing abo 12% of
he pop la ion o ld ide. The incidence i e ima ed a 600,000 in he U.S. Be een he age of 20 o 49; kidne one affec men mo e f e en l
han in omen (2 o 1). The life ime ec ence a e i highe in male han in female . Thi fac i a ib ed o he inc ea ing incidence of obe i d e
o poo die a habi and lack of ph ical ac i i .

Pa h h i l g
Renal one fo ma ion in ol e ph icochemical change and ine pe a a ion. In he e ing of pe a a ion, ol e p ecipi a e in he ine
leading o n clea ion and c al conc e ion . PH and pecific concen a ion of e ce b ance infl ence he an fo ma ion of a li id o a olid. In
e pec o neph oli hia i , pe a a ion of one-fo ming con i en like calci m, pho pho , ic acid, o ala e, c ine, and lo ine ol me a e
i k fac o fo c alli a ion.[7] Neph oli hia i i p e en able b a oiding pe a a ion.

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25/4/2021 Ne h li hia i - S a Pea l - NCBI B k helf

Hi ah l g
U ine mic o cop i ef l in anal ing he kidne one if he a e ob ainable ia ine aining. Belo a e he c al fo ma ion picall
a ocia ed i h each one pe [8]:

Calci m o ala e: en elope o d mbbell- haped

Calci m o ala e i he p ima componen of he majo i of one . The picall occ in he e ing of h pe calci ia,
h pe o al ia, h pomagne ia, h pe c in ia, h poci a ia.

Calci m pho pha e: amo pho , edge- haped p i m in o e e

Magne i m ammoni m pho pha e: coffin lid haped

Al o kno n a i e one , een in infec io one . In he e ing of infec ion i h bac e ia ha p od ce ea e, ch a

Poe mi abili , Kleb iella pne monia, En e obac e , and P e domona ae gino a. The ea e p od ce ammonia and CO2,
hich c ea e ba ic pH ine (>7).

U ic acid: homboid haped

The e one a e picall idiopa hic. The occ in pa ien ho e die a e high in p o ein, hich acidifie ine pH (<7),
allo ing fo ic acid one fo ma ion.

C ine: he agon- haped

The e one a e ca ed b a gene ic defec in he an po of he amino acid c ine, e l ing in h pe c in ia.

Hi a d Ph ical
Pa ien i h neph oli hia i , hen limi ed o he kidne , ill be a mp oma ic. The common mp om a ocia ed i h kidne one , incl ding ac e
pain adia ing o he g oin, occ once he one begin de cending he e e f om he kidne . I i of en de c ibed a d ll, colick , ha p, and
e e e pain. The pain i of en a ocia ed i h na ea and omi ing d e o he e e i of pain. The e mp om a e a ib ed o he pe i al i of he
geni o ina ac moo h m cle again he one. Hema ia i commonl epo ed a ell, d e o he inj again he geni o ina ac
econda o he one; hi i confi mable ia inal i .

If he one become infec ed, pa ien ma de elop fe e , chill , o o he ign of o ening emic ign of infec ion (i.e., hock). The ph ical
e am ma e eal co o e eb al ende ne . Ob c ion can occ , and p eloneph i i i h conc en h d oneph o i can e l . Thi i a ion can
be e e e and life- h ea ening, e i ing eme genc decomp e ion ge .

E al a i
Labo a o e oa e enal f nc ion, incl ding ei he a ba ic o comp ehen i e me abolic panel, ma be ed. Addi ionall , a inal i , ine
elec ol e , and ine pH can help di ec o a d a pecific pe of one.

A KUB (kidne - e e -bladde ) X- a i al o an op ion; ho e e , ic acid one a e diffic l o a e i h hi imaging. A CT of he abdomen and
pel i i ho con a can al o be pe fo med and ha highe en i i i . Con a medi m i picall a oided hen he e i a conce n fo a kidne
one a enhancemen of he e el and e e can ob c e one finding .

T ea e Ma age e
Kidne one a e e emel painf l. Pain con ol i of mo impo ance i h NSAID b dec ea ing moo h m cle im la ion and e e al pa m.
Addi ionall , i i e en ial o inc ea e fl id in ake. Tam lo in, ma al o aid one pa age, and al o ed ce moo h m cle im la ion. I i picall
ef l in ho e in he di al e e and i e be een 5 o 10 mm.

S one g ea e han 6mm a e likel o e i e ome in e en ion, incl ding pe c aneo neph oli ho om , igid and fle ible e e o cop , and hock
a e li ho ip .[9]

Di e e ial Diag i
Condi ion li ed belo ma mimic neph oli hia i -ind ced flank pain:

P eloneph i i , hich picall p e en ihp ia, fe e , chill and flank pain

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