crystalline mineral deposits → migrate + obstruct ureter → renal colic pain

Classic: 💥Colic wave pain+ 🩸Hematuria

severe: UREMIC SYNDROME + SEPSIS

= site of pain

• Diet
• reduced water intake
• disorders leading to high Ca
• HT
• DM

• calcium oxalate - most common 75%
• calcium phosphate - 15%
• uric acid - 10%
• struvite, cysteine - rare

• hypercalciuria + oxalaluria due to any cause (hPTH)
• obstruction of the ureter or UPJ
• animal protein intake, vitC + D intake

🟡 Urease-producing germs = Proteus + Klebsiella → only in upper UTI

• Ions (Ca, P)
• Urea + Crea
• Uric acid
• PTH
• CRP, WBC
• Hb, Hct

• Dipstick - 🩸 Hematuria
• 🧫 Infection (Leu, nitrate,ph,culture)

US 📷 → Hydronephrosis? Stone?

→ CT 📷 (without contrast) → Confirm diagnosis

KUB 📷 → radioopague; in uric acid → detection with IVP

with contrast: Retrograde pyelography or UroCT → if stone removal is planned

• Pain control → NSAID, Opiates, warming,
• MET: alpha-blocker + ca-channel blocker (see below) 📷
• UTI + Sepsis → AB
• Prevention + Recurrance
• Diet →VitC, animal prot, Na, Ca, purine in uric acid
• sufficient Fluid intake → 2.5-3L/day
• sodium restriction if high excretion
• Drugs → thiazide
• Lifestyle advide → normal BMI
• treat Hyperparathyroidsm
• Urologic intervention