YAYASAN PENDIDIKAN HARAPAN UTAMA

SMA HARAPAN UTAMA

TERAKREDITASI “A”
SATUAN PENDIDIKAN KERJASAMA
SS : 302006210017 NPSN : 11003004 NIS : 300330
Jl. Rosedale Simpang Franky Batam Center, Batam – Indonesia 29400
Telp: ( 0778 ) 472804 Fax: ( 0778 ) 472584 – Email: smaharapanutama@gmail.com

Biology Case Study

Kidney Stones

XI IPA Group 6

Leader: Yoshua Hares

Ivanna Callista

Keisya Ang

Lee Selly

Vivian

Advisor:

Ms. Andrelyn B.Navara

 CHAPTER 1

INTRODUCTION

Kidney stones (also called renal calculi, nephrolithiasis or urolithiasis)

typically form in the kidney and leave the body in the urine stream. Kidney
stones are solid masses that form in the kidney when there are high levels of
calcium, oxalate, cystine, or phosphate and too little liquid. A small stone
may pass without causing symptoms.  If a stone grows to more than 5
millimeters (0.2 in), it can cause blockage of the ureter, resulting in severe
pain in the lower back or abdomen it can also result in blood in the urine,
vomiting, or painful urination. About half of the people who have had a
kidney stone will have another within ten years.

Most stones pass on their own, but medical procedures are used to
remove some kidney stones. When your body has too much of certain
minerals, and at the same time doesn’t have enough liquid, these pebble-like
objects can form. The stones can be brown or yellow, and smooth or rough.
Both men and women can get kidney stones, but men’s chances of getting
them are about double that of women’s.

Risk factors include high urine calcium levels; obesity; certain foods;

some medications; calcium supplements; hyperparathyroidism; gout and not
drinking enough fluids.

When a stone causes no symptoms, no treatment is needed,

otherwise pain control is usually the first measure, using medications such
as nonsteroidal anti-inflammatory drugs or opioids. Larger stones may be
helped to pass with the medication tamsulosin.

The only way to know for sure that you have a kidney stone is to see a doctor
so she can make a diagnosis. Some tests for Kidney Stones are imagining
test which are X-rays, CT scans, or Ultrasound. Blood scans and urine scans
can also be used to detect stone-forming. A lab can test it for minerals to
see if medication might prevent more stones with medicines, calcium
channel blockers and alpha-blockers, potassium citrate or sodium citrate,
surgery, and shock wave lithotripsy

 Struvite stones: Infections, especially in the urinary tract, can cause

this kind of stone.
 Cystine stones: inherit the possibility of getting them from your
parents, both of whom would have to have the same type of genetic
mutation.
 Calcium stones: more common in metabolic conditions, such as renal
tubular acidosis. May also occur in the form of calcium phosphate.
 Uric acid stones: when urine is persistently acidic.

Definition of terms:

o ureter: the duct by which urine passes from the kidney to the bladder
or cloaca.
o Abdomen: body space between the thorax (chest) and pelvis. 
o obesity: abnormal or excessive fat accumulation that presents a risk to
health.
o hyperparathyroidism: abnormally high concentration of parathyroid
hormone in the blood.
o gout: common and complex form of arthritis that can affect anyone.
 o opioids: compound resembling opium in addictive properties or
physiological effects.
o tamsulosin: alpha-blocker that relaxes the muscles in the prostate and
bladder neck, making it easier to urinate. 
o X-rays: a type of radiation called electromagnetic waves.
o CT scans: a series of cross-sectional X-ray images of the body.
o Ultrasound: sound or other vibrations having an ultrasonic frequency,
particularly as used in medical imaging.

RESEARCH FRAMEWORK

Read and Take notes.

examine
the case highlight important
thoroughly keys.
Identify two to five key problems.
Focus your How did they spread?
analysis How is kidney stones diagnosed?
What are the treatments for kidney stones?
Uncover Review course reading, e-
possible source, and duscussions.
solutions Do some online research.

Select the Consider strong

best supporting evidence,
solution pros, cons.
 CHAPTHER 2

REVIEW OF RELATED LITERATURES

The Sign and Symptom of Kidney Stone

A kidney stone usually will not cause symptoms until it moves around within
your kidney or passes into your ureters. At that point, you may experience
these signs and symptoms:

 Severe, sharp pain in the side and back, below the ribs
 Pain that radiates to the lower abdomen and groin
 Pain that comes in waves and fluctuates in intensity
 Pain or burning sensation while urinating

Other signs and symptoms may include:

 Pink, red or brown urine

 Cloudy or foul-smelling urine
 A persistent need to urinate, urinating more often than usual or
urinating in small amounts
 Nausea and vomiting
 Fever and chills if an infection is present

How Is The Kidney Stone Diagnosed?

There are several test to diagnosed Kidney Stone.They are:

•Urine tests to check for infections and pieces of stones.

•An examination of any stones that you pass in your pee.

 •Blood tests to check that your kidneys are working properly and also
check the levels of substances that could cause kidney stones, such as
calcium.

How Is Kidney Stone Treated?

If your kidney stone is small, your doctor may tell you to take pain medicine
and drink plenty of fluids to help push the stone through your urinary tract.

If your kidney stone is large, or if it is blocking your urinary tract, additional

treatment may be necessary.They are:

• Shock wave lithotripsy

• Ureteroscopy

• A surgery called percutaneous nephrolithotomy

 CHAPTER 3

THE SUBJECT

Name: Gary Williams

Symptoms of kidney stones: Gary was debilitated couldn’t walk, couldn’t sit
up straight, couldn’t find relief. Blood in Gary's urine. 
Gary treatment: The very first one, the treatment options were that to take
their medication and see if it would pass naturally which it did. But three
years later Gary had the same sort of symptoms and blood in Gary's urine
and the pain. Gary went back to the emergency room and hoping it would
pass naturally but it didn’t. So Gary must undergo surgical treatment and
the surgical treatment for stones in the ureter is called URI Rasca pee this is
where the doctor looks in Gary's bladder and go up to the stone with a
camera scope and break up the stone. Within 2 hours, the doctor retrieved it
and put a stent in that period. When Gary had to stand in, it would seem
that Gary always had to go to the bathroom whether Gary did or not and
that’s the sensation that Gary felt for the entire week that Gary had it is. It
may irritate the bladder enough. 
- The stent is a tube kind of like it to about as long as a piece noodle of
spaghetti. There’s a curl on each end the one curl holds it up into the kidney
the other curl keeps it down in the bladder what that does is allows the
kidney to drain, allows the stones to hopefully kind of trickle on down and
out.
- So if you have these things drinking water will help, sometimes sitting in a
tube of water or taking a hot shower helps, helps with that discomfort from
the stint.
 CHAPTER 4

CONCEPT SYNTHESIS

SUBJECT SYMPTOMS Affect On CURRENT

Treatment STATES
Couldn’t walk When Gary had
Garry Williams to stand in, he
Couldn’t sit up always had to Recovered
Man straight go to the
bathroom
Couldn’t find whether Garry
relief did or not and
he felt that for a
week.
 FRAMEWORK OF THE STUDY

Urinary supersaturation
Oxidative stress
If you often hold urine for too long, it can cause urine supersaturation. Urine
supersaturation is an increase in the concentration of a urine solution due to
Is a condition in which the number of free radicals in the
lack of fluids or an increase in the amount of solution, triggering the
body exceeds the body's capacity to neutralize them.
formation of calcium, uric acid, or phosphate crystals.

Cell injury and cell membrane

rupture
Crystal Nucleation

Supersaturated urine (thick / concentrated) will start

to form solid crystals, and become a nucleus

Crystal Growth

When the nucleus is formed, the crystals will continue

to grow in size until they reach their maximum point.

Crystal Aggregation

When a crystal cannot grow anymore, it will combine with other

crystals to form larger particles. This is why a blockage in the urethra
forms, which can give rise to the symptoms already mentioned .
 CHAPTER 5

RECOMMENDATION

Drinking a lot of fluid is important for treating and preventing all types of
kidney stones. Staying hydrated (having enough fluid in your body) will keep
your urine diluted. This makes it harder for stones to form.

 Water is best.
 You can also drink ginger ale, lemon-lime sodas, and fruit juices.
 Drink enough liquids throughout the day to make at least 2 quarts (2
liters) of urine every 24 hours.
 Drink enough to have light-colored urine. Dark yellow urine is a sign
you are not drinking enough.

Limit your coffee, tea, and cola to 1 or 2 cups (250 or 500 milliliters) a day.
Caffeine may cause you to lose fluid too quickly, which can make you
dehydrated.

Follow these guidelines if you have calcium kidney stones:

 Drink plenty of fluids, particularly water.

 Eat less salt. Chinese and Mexican food, tomato juice, regular canned
foods, and processed foods are often high in salt. Look for low-salt or
unsalted products.
 Have only 2 or 3 servings a day of foods with a lot of calcium, such as
milk, cheese, yogurt, oysters, and tofu.
 Eat lemons or oranges, or drink fresh lemonade. Citrate in these foods
prevents stones from forming.
 Limit how much protein you eat. Choose lean meats.
 Eat a low-fat diet.
Avoid these foods if you have uric acid stones:

 Alcohol
 Anchovies
 Asparagus
 Baking or brewer's yeast
 Cauliflower
 Consommé
 Gravy
 Herring
 Legumes (dried beans and peas)
 Mushrooms
 Oils
 Organ meats (liver, kidney, and sweetbreads)
 Sardines
 Spinach

Bibliography

https://en.wikipedia.org/wiki/Kidney_stone_disease#Diagnosis

https://www.webmd.com/kidney-stones/default.htm

https://www.hindawi.com/journals/au/2018/3068365/

https://medlineplus.gov/ency/patientinstructions/000135.htm