Rav Kidny Stones

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metabolic abnormality in patients with calcium-containing stones.

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* Hypercalciuria is the most common metabolic abnormality in patients with calcium-containing stones.

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An increase in dietary calcium intake paradoxically decreases the risk of c

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* An increase in dietary calcium intake paradoxically decreases the risk of calcium oxalate stone formation and recurrence, and thiazide diuretics can further decrease the recurrence of these stones in selected individuals.

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have an increased risk for struvite stones.

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* Women with recurrent urinary tract infections with urease-splitting Klebsiella and Proteus species have an increased risk for struvite stones.
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have an increased risk of uric acid stone formation.

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Patients with hyperuricosuria, especially those with urine uric acid levels greater than 1000 mg/24 h (5.9 mmol/d), have an increased risk of uric acid stone formation.
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pass spontaneously with supportive treatment.

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Approximately 90% of kidney stones less than 5 mm in diameter pass spontaneously with supportive treatment.

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Patients with kidney stones usually have intact kidney function, and the presence of acute kidney injury is suggestive of

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Patients with kidney stones usually have intact kidney function, and the presence of acute kidney injury is suggestive of bilateral obstruction, obstruction in a solitary kidney, volume depletion, or sepsis.

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The gold standard to determine kidney stone composition is

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* The gold standard to determine kidney stone composition is to obtain the stone by straining the urine and then performing stone analysis.

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the gold standard for diagnosing kidney stones.

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* Noncontrast helical abdominal CT is the gold standard for diagnosing kidney stones.
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Asymptomatic kidney stones found on imaging studies do not

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Asymptomatic kidney stones found on imaging studies do not require urgent stone removal.
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In patients with an acute attack of kidney stones .. tx

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In patients with an acute attack of kidney stones, NSAIDs or narcotic agents can be used to relieve pain and a calcium channel blocker or α-blockers may help to increase the rate of spontaneous stone passage.
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is indicated for stones less than 1 cm in diameter located in the kidney and upper urinary tract.

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Extracorporeal shock-wave lithotripsy is indicated for stones less than 1 cm in diameter located in the kidney and upper urinary tract.
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Percutaneous nephrolithotomy is indicated for

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Percutaneous nephrolithotomy is indicated for stones larger than 1 cm in diameter, staghorn calculi, and cystine stones that are resistant to extracorporeal shock-wave lithotripsy and in patients with urinary tract abnormalities.
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Ureterorenoscopy

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Ureterorenoscopy is recommended to remove kidney stones in the distal ureter or to remove stone fragments caused by extracorporeal shock-wave lithotripsy.
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The best prevention of recurrent kidney stone disease is

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The best prevention of recurrent kidney stone disease is consumption of more than 2 L of fluids daily and modification of identifiable metabolic factors and diet.
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A causal association may exist between kidney stones

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A causal association may exist between kidney stones and progression to chronic kidney disease or end-stage kidney disease.