Urinary+Calculi

Western Diagnosis stones in the urinary tract

Etiology
1. supersaturation of urine with stone-forming salts 2. preformed nuclei of stones 3. abnormal crystal growth inhibitors 4. 80% calcium oxalate a. low water intake b. high urinary oxalate - consumption of foods high in oxalate: cocoa, tea, beer, rhubarb, dark leafy green veg, beans, beets, berries, nuts, wheat germ c. high urinary calcium d. diet high in meat, sugar, caffeine

Signs & Symptoms
1. asx 2. back pain, renal colic a. if renal calyces, renal pelvis, or ureters obstructed 3. suprapubic pain if in bladder 4. excruciating intermittent pain a. from flank or kidney area across abdomen along course of ureter b. possibly radiating into genitals and down medial thigh 5. N, V, abd distention 6. chills, fever, hematuria, urinary frequency 7. CVA tenderness

Diagnosis
1. clinical suspicion 2. UA a. hematuria b. inc crystals 3. x-rays 4. IVU - to determine extent of obstruction

Treatment
1. may pass spontaneously 2. ESWL - extracorporeal shock wave lithotripsy (US) 3. surgery 4. for calcium oxalate stones: a. INCREASE WATER b. acid urine via vit. C or cranberry juice c. dietary changes to reduce risk factors d. Mg 300 mg/d e. vit. B6 150 mg/d