What are special considerations in the drug therapy of nephrolithiasis? Potassium citrate, and not sodium citrate, for urine alkalinization to a pH > 7.0 is recommended for uric acid and cystine stones. Sodium citrate increases urinary sodium and calcium, and in alkaline urine, sodium urate may increase calcium stone formation. Cystine stone formers require higher …
Which medications are used to treat various stone-forming conditions Oral Drug Therapy for Renal Stones. DISORDER DRUG DOSAGE Absorptive type I HydrochlorothiazidePotassium citrateCellulose sodium phosphateMagnesium gluconateMagnesium oxide 12.5–25 mg twice daily10–30 mEq three times daily5 g 1–3 times/day with meals1–1.5 g twice daily400 mg twice daily Absorptive type II Hydrochlorothiazide 12.5–25 mg twice daily Renal …
How do radiographic tests help to evaluate patients with renal stones? A plain radiograph of the abdomen (kidney–ureters–bladder [KUB]) should be obtained in all stone formers and shows stones with the following features: calcium (small, dense, and circumscribed); cystine (faint, soft, and waxy); and struvite (irregular and dense). Uric acid, xanthine, and indinavir stones are …
What are the characteristics of urinary crystals in patients with renal stones? Calcium oxalate monohydrate crystals may be dumbbell shaped, needle shaped, or oval, with the last resembling red blood cells. Calcium oxalate dihydrate crystals are pyramid shaped and have an envelope appearance. Calcium phosphate and uric acid crystals are too small for standard light …
Characteristics of urinary crystals in patients with renal stones Read More »
What is the clinical significance of the urinalysis in patients with renal stones? Most stone formers have macroscopic or microscopic hematuria and may have some crystalluria. The remainder of the urinalysis is usually normal. Crystals are normally absent in warm and freshly voided urine, and if present suggest a diagnosis. However, most urine specimens cool …
What is the therapeutic approach to patients with kidney stones? Kidney stones do not require procedural intervention unless they are associated with or are likely to cause pain, obstruction, infection, or significant bleeding. Ureteral stones may also be treated conservatively (monitored) if there is no renal failure, fever, obstruction, infection, or pain. Pain can be …
What tests are appropriate in the diagnosis of kidney stones? Perform a complete urinalysis with focus on pH, hematuria, pyuria, bacteriuria, and crystalluria. If pH is high or there is bacteriuria, order a urine culture. Perform appropriate radiographic studies (see question 34). Have the patient strain all urine and save the stone, if passed, for …