Nephrolithiases and Urolithiasis

Nephrolithiasis and Urolithiasis
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Nephrolithiasis and Urolithiasis
Nephrolithiasis and Urolithiasis are conditions where stones or calculi form in the kidney or urinary tract. They can be composed of calcium oxalate or calcium phosphate and less frequently uric acid. When stones or calculi become lodged in the tract, an extremely painful situation develops. The stone may be small in the form of gravel or large enough to require surgery.
1 What are the factors that increase the risk for the development of renal calculi?
Males are more likely to develop renal calculi as compared to female thus suggesting a possible link between gender and the condition (Muhbes, 2012). Anatomical differences between males and females in terms of the length of the urethra have been suggested as the risk factor. Males have a longer urethra compared to the females and this encourages the accumulation and stagnation of urine in the bladder for a prolonged period. Gender is therefore a risk factor for the development of renal calculi.
History of urinary tract infection (UTI) has also been cited as a risk factor for renal calculi development. According to Muhbes (2012), the bacterial infections during UTIs result in a change in pH or an alteration in acid-base balance thus triggering the development of urinary calculi. UTIs can also cause a disturbance to the normal flow of body fluids and encourage the formation of stones or calculi. Other diseases that increase the risks of kidney stones include chronic metabolic acidosis, gout, hyperthyroidism, hypertension, insulin resistance, and surgical menopause (Frassetto & Kohlstadt, 2011).
Genetics or family history is a possible risk factor for hypercalciuric nephrolithiasis where there may be a derangement in the genes coding for a number of ion channels, transporters, and receptors. For instance, in Bartter syndrome which is a monogenic (one defective gene) autosomal recessive disorder, mutations in a bumetanide-sensitive Na-K-Cl (NKCC2) cotransporter, the voltage-gated channel, CLC-Kb, or the renal outer-medullary potassium channel (ROMK) have been identified (Stechman, Loh, & Thakker, 2009)
2 What are the clinical manifestations of a kidney or urinary stone?
Hypocitraturia is a common clinical manifestation of kidney or urinary stones (Sepahi, Heidari, & Shajari, 2010). Among patients with the condition, the excretion of urinary citrate is significantly reduced. Citrate is known to be a natural inhibitor of calcium phosphate and calcium oxalate crystallization. Some patients present with hyperuricosuria. Hematuria, abdominal pain, dysuria, and fever are other clinical manifestations and symptoms among patients with nephrolithiasis and urolithiasis (Sepahi, Heidari, & Shajari, 2010).
3 What are the diagnostic tests used to confirm the presence of a stone?
Laboratory diagnostic tests used to confirm the presence of kidney ston...