Kidney stones & Hydronephrosis

When the level of insoluble salts or uric acid in the urine is high, or the urine lacks citrate (a chemical that normally inhibits the stone formation), or insufficient water is present in the kidneys to dissolve waste products, kidney stones form. Most stones form within the kidney, but they can from anywhere within the system.

-(renal calculi) -Hard insoluble crystallised minerals and salts that have formed from filtrate. -High concentration of salts and minerals from these crystals.

Collecting tubules or the renal papillae, then they pass into the real pelvis where they may increase in size. Can also pass to the bladder.

Are calcium compounds that chemically bind to oxalate or phosphate. Account for approx 60-80% of all urinary stones.

Account for 5-10% of all stones, they are more common in men.

Are more common in women and their formation is linked to chronic bacterial UTIs and frequent catheters. Account for 10-15% of all stones.

Are the least common and form due to rare inherited condition where there are large amounts of cystine (an amino acid)

One in 11 people get stone symptoms during their life times. Men are affected slightly more than woman, especially caucasians. Can affect all ages, but the peak age for the first stone is around 45.

Both intrinsic and extrinsic factors. A diet high in animal protein that contains lots of sugar and salt. Poor fluid intake. If the patient has already had a stone there is a 50% chance that they will form another one in the next 10 years.

Age and gender Ethnicity Diet Chronic dehydration Obesity Medications Family history Gastro conditions Conditions affecting urinary volume

• Once any solid or debris forms, deposits continue to build up on this focus, and then form a large mass. • Cell debris from infections can also cause a focal point. • Immobility may cause changes in the urine due to stasis in its flow, leading to stone formation • Stones usually cause symptoms only when they obstruct the flow of urine • They can cause infection as they lead to stasis of the urine which in turn causes tissue irritation.

-Frequently asymptomatic -Stones that obstruct the ureter produce acute sever pain that originates in the flank area and radiates to lower abdomen -Colic produces severe cyclic pain that occurs when the ureter contracts forcefully trying to push the stone to the bladder.

Analgesia Fluid replacement Anti emetics Hospital admission Surgery

A condition where the kidneys become swollen as a result of an obstruction. Obstruction of urine leads to increased size of renal pelvis. Causing reflux damage to the kidney and can result in permanent loss of function.

Kidney stones Congenital blockages Blood clots Scarring of tissue Tumors/some cancers Enlarged prostate Pregnancy UTI’s

Diagnosed with ultrasound and may require immediate catheterisation or surgery.