Chapter

Disorders of renal calcium handling, urinary stones, and nephrocalcinosis

Elaine M. Worcester, Andrew P. Evan and Fredric L. Coe

in Oxford Textbook of Medicine

Published on behalf of Oxford University Press

Published in print May 2010 | ISBN: 9780199204854
Published online May 2011 | e-ISBN: 9780199570973 | DOI: http://dx.doi.org/10.1093/med/9780199204854.003.2114_update_001

Series: Oxford Textbooks

Disorders of renal calcium handling, urinary stones, and nephrocalcinosis

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Renal stones are common, with a prevalence of about 5% in the United States of America. Acute stone passage almost always produces the severe pain of renal colic, but stones are often asymptomatic and discovered incidentally on imaging.

The initial evaluation of patients with renal colic optimally includes noncontrast CT, which can accurately visualize the size and location of stones in the urinary tract. Initial management of stones less than 5 mm in diameter in patients without anatomical abnormalities of the urinary tract is to provide adequate analgesia, followed by watchful waiting to allow time for stone passage. The presence of urinary tract infection, inability to take oral fluids, or obstruction of a single functioning kidney requires hospitalization and active management. Once the acute episode of stone passage or removal is over, thought should be given to diagnosis of the underlying causes of stones, and steps taken towards prevention. Stone analysis is the cornerstone of diagnosis....

Chapter.  7294 words.  Illustrated.

Subjects: Nephrology

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