Critical Thinking: Treatment of Renal Calculi
Renal calculi, also known as kidney stones or nephrolithiasis, are hard, crystalline mineral substances formed within the urinary tract or kidney, symptomized by flank pain, and hematuria (Curhan, 2011). Though some run within the lineage, their occurrence is prompted by a decrease in volume of urine, or an excess of substances that form stones within the urine. To confirm the presence or absence of kidney stones, various diagnostic tests are carried out, including blood tests to check the levels of calcium, uric acid, phosphorus, and electrolytes; kidney function tests; urinalysis, which is done to check for red blood cells in the urine, or crystals; and stone type examinations. In addition, abdominal CT scans can also be carried out, as well as MRI, X-rays, Ultrasound and Intravenous pyelogram (IVP) of the kidney and abdomen (Pietrow, 2007).
Treatment of kidney stones is dependent on the cause of the calculi, which is specific for every type of stone. The most common ones are calcium stones, cysteine stones which form in people with cystinuria, struvite stones mostly found in women, uric acid stones more common in men than women, and other substances including triamterene, indinavir and acyclovir medications (Pietrow, 2007).
Usually, small stones pass on their own with intake of fluids. However, bigger stones may need some medications to decrease their formation and help to fragment them. Allopurinal is used for uric stones; antibiotics are common for struvite stones; phosphate solutions for calcium stones; sodium citrate and thiazide diuretics for general use (Curhan, 2011). Surgical procedures like lithotripsy, percutaneous nephrolithotomy and ureteroscopy may be necessary if the condition is worse, as is deemed by the doctor (Pietrow, 2007).
References
Curhan, G. C. (2011). Nephrolithiasis. In: Goldman, L. & Schafer, A.I., (eds.). Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier.
Pietrow, P. K. (2007). Preminger GM. Evaluation and medical management of urinary lithiasis. In: Wein AJ, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: Saunders Elsevier.
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