Renal Calculi

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Renal Calculi
Kristan Michele Heil
Our Lady of the Lake College

Renal Calculi
Renal calculi, commonly called kidney stones, are one of the most common, painful disorders of the urinary system. The condition of having kidney stones is referred to as nephrolithiasis. These stones are usually formed inside of the kidney and can be composed of various elements collected in the human body. Some stones may pass right through the urinary system never causing a problem, while others may cause a great amount of pain by blocking the flow of urine out of the body. Various precautions can be taken in order to avoid this painful condition. Affected individuals should be aware of the many different types, causes, treatments and ways of prevention to further inhibit the formation of kidney stones. In the human body, the two bean-shaped kidneys play a central role in filtering the blood and removing wastes and excess water from the body in the form of urine. Urine is removed from the body via the excretory system, consisting of branches in the kidneys and renal pelvis, ureters, the urinary bladder and urethra. The kidneys are located posterior to the peritoneum in the abdominal cavity. The interior kidney has a number of urine-draining branches termed the major and minor calyces, and an expanded portion called the renal pelvis, which together are known as the pelvicaliceal system (Frank, 2007). Extending inferiorly from the pelvis of each kidney is a ureter. Ureters are long, tube-like structures connecting each kidney to the urinary bladder. The urinary bladder serves as a vessel to urine collected by the kidneys. The urethra, located on the inferior surface of the bladder, serves as the exterior opening to the body to remove the urine and wastes from the bladder. Formation of stones in the kidneys is most commonly caused by excess substances in the urine. These substances combine to form small crystals which eventually combine to form stones. Stones are most commonly organized into four common types, calcium oxalate, struvite, uric acid and cystine, each having their own cause. A majority of kidney stones are calcium stones, with calcium oxalate and calcium phosphate accounting for approximately 80% of all of these stones, uric acid about 9%, and struvite approximately 10%, leaving only 1% for all the rest (cystine, drug stones, ammonium acid urate) (Evan, 2010). Calcium is used in the body by the bones and muscles and any leftover calcium is transported to the kidneys. In most cases, the body flushes out the excess calcium in the urine, but occasionally the calcium will remain in the kidney and form stones. It was once believed an excessive amount of calcium was the sole cause of calcium oxalate stones, but this has since been disproven. According to studies done by Dr. Marc Micozzi, when fifty normal, healthy patients were compared to seventy five patients with kidney stones, their urinary oxalate levels were uncannily identical. Therefore, it is uncertain that excess oxalate can be the true and only cause of the calcium stones (Micozzi, 2007). Struvite stones are most often formed due to an infection of the urinary tract with bacteria. While these stones rarely occur, they are more prevalent in women with urinary tract infections and with patients who have indwelling infected devices in their urinary systems (Jacobs, & Opolinsky, 2009). If left untreated, these struvite stones may cause serious renal damage and could lead to renal failure. Uric acid and cystine stones account for a small number of stones produced each year. Uric acid can enter the body by way of purines such as fish, meat and poultry. This type of stone is common in patients who have a high production of uric acid, such as patients with gout. Though urinary uric acid is a contributing factor in patients with gout, it is likely not the single cause of stone formation. Studies have shown that patients infected with gout have a threefold greater chance...
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