Incidence and type of stone formation varies based on metabolic, dietary, genetic, climatic, and lifestyle factors. Calcium oxalate stones caused by hypercalcemia are the most common form of renal calculi. Hypercalcemia increases urine pH and forms precipitated crystals that develop into kidney stones. Renal calculi can be categorized as calcium oxalate, calcium phosphate, uric acid, cystine, and struvite (magnesium ammonium phosphate).
The obstructing kidney stone causes stretching, dilation, and spasm of the ureter. Sudden severe flank pain is a characteristic symptom of a kidney stone. The location of the kidney stone determines the patient's type of pain. The sharp pain may also be felt in the back or lower abdomen. The severe pain may also lead to symptoms of nausea and vomiting. Patients with non-obstructing stones may not experience pain.
Pain caused by renal colic radiates toward the bladder as the stone progresses downward. Pain in the groin may also occur. Men often experience testicular pain while women may complain of labial pain.
Renal stones passing through the ureter cause renal colic. This wavelike rhythmic pain makes staying still difficult in patients. To help ease their discomfort, they frequently alternate positions from walking to sitting to lying down. This often is referred to as the 'kidney stone dance.'
Individuals with renal calculi may demonstrate symptoms of urinary tract infection. Manifestations include mild shock with cool, moist skin, dysuria, fever, and chills.
Kidney stones may obstruct the renal structures and block normal urine flow. Obstruction of the bladder outlet may lead to acute urinary retention.
Kidney stones may cause trauma to the renal structures and lead to bleeding. The presence of hematuria, or blood in the urine, may suggest renal calculi.
Nearly 50% of patients with renal calculi will experience kidney stone recurrence. A 24-hour urinary analysis of calcium, phosphorus, magnesium, sodium, citrate, and uric acid will help determine the cause of renal calculi and determine interventions to prevent reoccurrence. Prescription medications and adequate hydration will help prevent stone recurrence.
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