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Pathology - Nephrolithiasis
This condition most usually manifests as in the vignette, with patients complaining of relatively quick onset of acute flank discomfort spreading to the front of the abdomen on the affected side. While there are some established risk factors for development of renal calculi such as usage of certain medications (hydrochlorothiazide), certain medical disorders (gout, hypercalcemia), or excessive dietary consumption of oxalate (tea, spinach, others), most of the time the etiology is unclear. Evaluation of stone type (struvite vs. calcium oxalate vs. other) can help to identify likely causation in some cases. Stones form in the kidney and migrate down the ureters and eventually expelled in the urine or eliminated using ultrasonic lithotripsy if too large to pass through the ureter. Clinical findings include hematuria, which may be gross or microscopic and systemic signs of illness (fever, nausea, chills), which may occur as a result of acute urinary blockage. Males are afflicted more regularly; repeated episodes are prevalent and can progress to tubular scarring and ultimately renal parenchymal involvement and irreversible kidney disease.
This condition most usually manifests as in the vignette, with patients complaining of relatively quick onset of acute flank discomfort spreading to the front of the abdomen on the affected side. While there are some established risk factors for development of renal calculi such as usage of certain medications (hydrochlorothiazide), certain medical disorders (gout, hypercalcemia), or excessive dietary consumption of oxalate (tea, spinach, others), most of the time the etiology is unclear. Evaluation of stone type (struvite vs. calcium oxalate vs. other) can help to identify likely causation in some cases. Stones form in the kidney and migrate down the ureters and eventually expelled in the urine or eliminated using ultrasonic lithotripsy if too large to pass through the ureter. Clinical findings include hematuria, which may be gross or microscopic and systemic signs of illness (fever, nausea, chills), which may occur as a result of acute urinary blockage. Males are afflicted more regularly; repeated episodes are prevalent and can progress to tubular scarring and ultimately renal parenchymal involvement and irreversible kidney disease.
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