THE KIDNEY_4

BY DR.VENUGOPAL RAO
L.S

UROLITHIASIS
(RENAL
STONE,CALCULI)

1.

The calculi can arise at any level in the

urinary tract, frequently causing clinical
symptoms including obstruction ,
and
pain.
Theyulceration,bleeding
also predispose to renal
infection
There are 4 types of renal calculi and organic
matrix of mucoprotein.
About 70% of stones are calcium oxalate plus/
minus calcium phosphate. The calcium
containing stones are usually associated with
hypercalcaemia/hypercalciuria,hyperoxaluria
and hyperuricosuria are associated with
others.

2.About 15-20% are so called triple phosphate /

struvitestones composed of magnesium ammonium
phosphate.it is due to urea splitting bacteria that
convert urea to ammonia
3.5-10% are uric acid stones
4. 1-2% are made up of cystine.

Types of stones

1.
2.
3.

Calcium oxalate and

phosphate
Idiopathic
hypercalciuria(50%)
Hypercalciuria and
hypercalcaemia(10%)
Hyperoxaluria(5%)
Magnesium ammonium
phosphate(struvite)
Uric acid
cystine

percentage
70%

15-20%
5-10%
1-2%

pathogenesis
Increase

concentration of some
constituents, changes in urinary
PH,decreased urine volume and bacteria
all play a role in stone formation.
The loss of inhibitors of crystal
formation(eg;citrate,pyrophosphate,glycos
aminoglycans,osteopontin and an alpha
glycoprotein called nephrocalcin) may play
a pathogenic role in such cases.

nephrolithiasis

DISEASES OF RENAL BLOOD

VESSELS

1.
2.
3.
4.
5.
6.

These include
Benign nephrosclerosis
Malignant nephrosclerosis
Renal artery stenosis
Thrombotic microangiopathies
Atheroembolic renal diseases
Renal infarcts