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| Nephrolithiasis |
| Etiology •Diet plays a part in stone formation. •Some cases are hereditary. •Some cases are due to inborn errors of metabolism such as gout and cystinuria. |
| Pathogenesis •There are four main types of stones - calcium oxalate, uric acid, struvite and cystine. •Stone nucleation usually occurs on pre-existing surfaces and growth is dependent on factors such as urine concentration, pH, and urine volume., |
| Epidemiology •Annual incidence of 7 to 21 cases per 10,000 persons in the United States. •Males are affected more often than females. •Peak age of onset between 20 to 30 years. |
| General Gross Description •Uroliths vary considerably in size, shape and color and are not particularly revealing as to their chemical content. •Urinary stones are sent for chemical analysis for more useful information. •Stones that develop in the renal pelvis and calyces can grow to conform to the contour of these structures and have the shape of a staghorn. •Staghorn calculi are usually associated with concomitant infection. |
| General Microscopic Description •Uroliths are not examined by microscopic sections. •Urinary stones are sent for chemical analysis for useful information. |
| Clinical Correlation •The most common clinical problem is stone passage manifested by abrupt onset of extreme flank pain radiating to the groin. •Hematuria, dysuria and frequency are common accompanying symptoms. •Stones less than 5 mm are likely to pass spontaneously. •Stones greater than 7 mm are unlikely to pass. |
| References • Cotran RS, Kumar V, Robbins SL: Robbins Pathologic Basis of Disease. 5th ed. Philadelphia, W.B. Saunders, 1994, pp. 984-985. •Primer on Kidney Diseases, 1994 (National Kidney Foundation (Greenberg A. editor). |
| Nephrolithiasis |
| Synopsis by: Harold Yamase M.D. (T71000M30000)[469] |
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