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Related Concept Videos

Urinary Tract Calculi II: Pathophysiology and Clinical Manifestations01:26

Urinary Tract Calculi II: Pathophysiology and Clinical Manifestations

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Renal calculi, commonly termed kidney stones, are crystalline solid masses that form in the kidneys but can occur at any point within the urinary system, encompassing the kidneys, ureters, bladder, and urethra.The pathophysiology of renal stones involves several key factors: supersaturation of the urine with stone-forming constituents, changes in urine pH, a decrease in urine volume, and the presence of substances that promote or inhibit stone formation.Supersaturation of Urine: This is the...
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Urinary Tract Calculi IV: Nutrition Therapy and Prevention01:27

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Management of renal calculi focuses on effective strategies like tailored nutrition and hydration therapy. Adjusting diet and fluid intake reduces stone formation and recurrence, making these interventions simple yet powerful in kidney stone prevention and management.Understanding Kidney StonesKidney stones form when calcium, oxalate, uric acid, and cystine concentrate and crystallize in urine. Factors contributing to their formation include genetic predisposition, certain medical conditions,...
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Urinary Tract Calculi III: Medical Management01:30

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The diagnosis of renal calculi involves several imaging techniques, including non-contrast CT scans and ultrasound. These methods help visualize kidney stones, assess their size and location, and detect possible obstructions. Additionally, Measuring urine pH is useful for diagnosing specific stone types, such as struvite (alkaline pH) and uric acid stones (acidic pH). Cystine stones are primarily linked to cystinuria, a genetic condition. A urinalysis helps detect blood in the urine (hematuria)...
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Urinary Tract Calculi V: Nursing Management01:28

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AssessmentSubjective Data: Obtain a detailed health history, including any recent or chronic urinary tract infections, periods of immobilization, previous episodes of renal calculi, and medical conditions such as gout, benign prostatic hyperplasia, or hyperparathyroidism. Review the medication history for drugs that may influence stone formation, including allopurinol, analgesics, loop diuretics, or thiazide diuretics. Document the use of long-term indwelling catheters and any past surgical...
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Urinary Tract Calculi VI: Surgical Management01:25

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Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...
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Urinary Tract Calculi I: Introduction01:28

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Renal calculi, or kidney stones, are solid deposits of minerals and salts formed inside the kidneys. In medical terminology, "calculus" refers to the stone itself, while "lithiasis" describes the process of stone formation. Depending on their location within the urinary system, these stones may be classified as either urolithiasis, when situated within the urinary tract, or nephrolithiasis, when located within the kidneys. Each term signifies the specific impact of the stone.Predisposition...
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The ROKS nomogram for predicting a second symptomatic stone episode.

Andrew D Rule1, John C Lieske2, Xujian Li3

  • 1Division of Nephrology and Hypertension, Department of Medicine and Division of Epidemiology, Department of Health Sciences Research, Division of Epidemiology, Department of Health Sciences Research, and rule.andrew@mayo.edu.

Journal of the American Society of Nephrology : JASN
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Summary

A new nomogram predicts the risk of a second kidney stone episode. This tool helps identify patients needing preventive therapy to reduce recurrence rates, which can reach 39% over 15 years.

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Area of Science:

  • Nephrology
  • Urology
  • Epidemiology

Background:

  • Limited evaluation and preventive therapy for first-time kidney stone patients.
  • Need for a predictive tool to optimize treatment strategies for stone recurrence.

Purpose of the Study:

  • To develop and validate a nomogram predicting symptomatic recurrence of kidney stones in first-time stone formers.

Main Methods:

  • Retrospective cohort study of 2239 adult first-time kidney stone formers (1984-2003) in Olmsted County, MN.
  • Manual review of medical records via Rochester Epidemiology Project to identify clinical predictors.
  • Development of a multivariable model and nomogram for recurrence risk assessment.

Main Results:

  • Symptomatic recurrence observed in 707 patients by 2012 (15-year rate: 39%).
  • Identified risk factors: younger age, male sex, white race, family history, prior stones, gross hematuria, stone location, and uric acid composition.
  • Nomogram scores stratified 10-year recurrence risk from 12% to 56%.

Conclusions:

  • The Recurrence of Kidney Stone nomogram effectively identifies individuals at high risk for a second symptomatic episode.
  • High-risk patients may benefit from medical intervention and are suitable candidates for prevention trials.