pathophysiology of nephrolithiasis, struvites stone (staghorn calculi)

NEPHROLITHIASIS : PATHOPHYSIOLOGY

Non modifiable factors:

-Age -Sex

Modifiable factors:

-Diet (unusually high in soy & fish sauce, bagoong, softdrinks, legumes, protein & salt)-Certain meds (Analgesics)-Low fluid intake-Urinary stasis-Smoking & alcoholic drinking-Gouty arthritis

Randall’s plaque

Nephrocalcinosis on proximal tubule

Uric acid ), ammonia phosphate , and calcium oxalate stone material deposition on proximal

renal tubule

Episodes of pain in side radiating in the back

Nidation of crystals or foreign bodies from the

supersaturated urine

PyuriaIncrease production of WBC

Urinary Tract Infection caused by urea splitting organism

Super saturation of urine by stone forming

constituents (↓OFI)

Hyperkalemia

Stones obstructing the kidneys

Stones formation <5mm in kidneys

Stone matrix & progression

MULTIPLE URINARY CALCULUS

Proteinuria(+1)

Staghorn calculus

Dysuria

Hematuria

Accumulation of stones & increasing in size

Progression of stones in Loop of Henle

Blood vessels wall surface attraction and erosion

Renal colic radiating to the back & leg

Bilateral swelling of the knees and adjacent parts

(Edema)

Nidation of crystals or foreign bodies from the

supersaturated urine

Increase production of WBC

Pyuria