This document discusses kidney stones, including that they are very common, affecting around 2% of the population. The peak age is 30-40 years old and they are more common in men. Recurrence rates are high at 40-70%. The document outlines predisposing factors like metabolic syndromes and lists the most common types of stones. It describes the presentation of colicky pain and hematuria. Investigation involves blood tests, urine tests and CT scans. Treatment focuses on analgesia, fluid intake, treating infections, and sometimes surgery or lithotripsy.

1. Ben Savage

2.  Epidemiology
 Predisposing factors
 Types of stone
 Presentation
 Investigation
 Management

3.  Very common – prevalence 2%
 Peak incidence 30-40yrs
 3:1 M>F
 Recurrence rate 40-70%
 50% symptomatic within 5yrs of discovery

4.  Usually idiopathic
 Metabolic syndromes
 Hypercalcuria present in 70% of stones
 Chronic hypercalcaemia
◦ Hyperparathyroidism, sarcoid, myeloma
 Repeated UTI
 Low fluid intake or high fluid loss
 Structural abnormalities
 Oxidate rich foods, e.g brocoli

5.  Calcium oxidate (75%)
 Triple phosphate (15%) – usually due to
infection
 Urate (6%) – hyperuricemia (GOUT)
 Cystine (1%) – inborn errors in metabolism

6.  Colicky loin to groin pain. Severe
 Haematuria
 Obstruction
◦ NB: Anuria is a medical emergency and requires
immediate intervention

7.  Bloods
 24hr urine and MC&S
 AXR
 CTKUB (gold standard)

10.  Adequate analgesia
 Increase fluid intake to >3L per day
 Treat any underlying infection
 Consider
◦ Surgery (20% of cases)
◦ Extracorporeal shock wave lithotripsy

11.  Very common
 Multiple types of stone
 CTKUB gold standard test
 Anuria is a medical emergency and requires
immediate intervention

12. Any Question