RENAL

CALCULI
BY: MR. HARPREET SINGH BURMI
 RENAL STONES
• DEFINITION
• UROLITHIASIS (URINARY CALCULI) MEANS STONE IN URINARY TRACT THAT
OCCUR DUE TO CONCENTRATION OF DISSOLVED MINERALS IN URINARY
TRACT.
• NEPHROLITHIASIS (RENAL CALCULI) MEANS STONE IN KIDNEY THAT OCCUR
DUE TO CONCENTRATION OF DISSOLVED MINERALS IN THE KIDNEY. 

• CALCULUS FORMATION AT ANY LEVEL IN THE URINARY COLLECTING SYSTEM

• KIDNEY (NEPHROLITHIASIS),
• URETER (URETEROLITHIASIS),
• BLADDER (CYSTOLITHIASIS),
 TYPES OF RENAL STONES

• COMMON STONES:
 OXALATE (CALCIUM OXALATE) (70%)
 PHOSPHATE (15%)
 URIC ACID / URATE (10%)
 CYSTINE (1-2%)
 TYPES OF RENAL STONES

• UN-COMMON
XANTHINE STONES
DIHYDROXY ADENINE STONE
SILICATE STONES
MATRIX
 ETIOLOGY
 HYPERPARATHYROIDISM
 INCREASE CALCIUM LEVEL
 ELEVATED URIC ACID(GOUT)
 EXCESSIVE INTAKE OF DIETARY CALCIUM
 INFECTION OF URINARY TRACT
 LOW FLUID INTAKE
 MEDICATIONS LIE DIURETICS
 FAMILY HISTORY OF STONE
 OBSTRUCTION OF URINARY TRACT
 HIGH MINERALS IN DRINKING WATER
 HIGH MINERAL AND PROTEIN CONTAINING DIET
 PREVIOUS HISTORY OF URINARY CALCULI
 PATHOPHYSIOLOGY
DUE TO ETIOLOGICAL FACTOR INCREASE LEVEL OF STONE FORMING CRYSTAL
IN URINE

CONCENTRATION OF STONE FORMING CRYSTAL IN URINARY TRACT

GROWTH CONTINUE BY AGGREGATION OF PARTICLES

FORMATION OF LARGER STONE

THESE PARTICLES MAY TRAVEL DOWN URINARY TRACT

STONE FORMATION
 CLINICAL MANIFESTATION
 SEVERE ABDOMINAL PAIN OR LOW BACK PAIN
 HAEMATURIA
 DYSURIA
 DISCOMFORT
 NAUSEA & VOMITING
 FEVER IF INFECTION IS PRESENT
 PAINFUL URINATION
 OLIGURIA
 PYURIA
 LOCAL TENDERNESS
 DIAGNOSIS
 HISTORY & PHYSICAL EXAMINATION
 X-RAY
 USG
 IVP
 URINE ANALYSIS
 BLOOD TEST- SERUM CALCIUM LEVEL, SERUM
URIC ACID LEVEL
 MANAGEMENT
 MANAGEMENT OF URINARY CALCULI
DEPEND SIZE & LOCATION OF STONE.
IF STONE IS LESS THAN 5MM IT IS
LIKELY TO PASS THROUGH THE URETER
AND SPONTANEOUSLY COME OUT WITH
ADEQUATE HYDRATION BUT IF STONE
IS MORE THAN 5MM THAN SURGICAL
MANAGEMENT IS INDICATED.
THANK YOU