Step I High Yield Renal Calculi

[J. Peterman]

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I keep getting questions about renal calculi - what causes them, how to get rid of them, what makes them worse, drugs, endocrinology, renal clearance.... Can someone give an explanation, or maybe a high-yield run down (anything that would be boards-worthy) of facts surrounding renal calculi and possible example questions. This is a specific topic, I know, but so far the question keeps popping up, so I think it's important. The latest one had to do with the effect of a thiazide diuretic on a patient with renal calculi. Another one asked about alkalinization of the urine... If you have a top 10 or even just 1 fact to contribute, I'd greatly appreciate it.

Thanks

 

[twintiger32]

I keep getting questions about renal calculi - what causes them, how to get rid of them, what makes them worse, drugs, endocrinology, renal clearance.... Can someone give an explanation, or maybe a high-yield run down (anything that would be boards-worthy) of facts surrounding renal calculi and possible example questions. This is a specific topic, I know, but so far the question keeps popping up, so I think it's important. The latest one had to do with the effect of a thiazide diuretic on a patient with renal calculi. Another one asked about alkalinization of the urine... If you have a top 10 or even just 1 fact to contribute, I'd greatly appreciate it.

Thanks

ok well, your 2 cases...

anything that increases the amount of calcium in the urine (hypercalciuria) will lead to calcium oxalate stones. thiazides help because they cause reabsorption of calcium...so less calcium in the urine.

regarding alkalinization, you get staghorn calculi (proteus infection, etc) causing magnesium ammonium phosphate stones...proteus alkalinizes the urine (ammonia), leading to this disease.