Renal Calculi (Uroliths or Kidney stones)

ICD-9: 592.0


Renal calculi are the most common cause of urinary obstruction. A renal calculus is a concentration of various mineral salts in the renal pelvis or the cuplike extension of the renal pelvis called the calyx of the kidney or elsewhere in the urinary tract. They can be small like a grain of sand or very large. Most stones develop in the kidney and are formed from calcium salts, uric acid, cystine, and struvite in descending order of frequency.

Renal Calculi


Renal calculi form as a result of a disturbance in the kidney’s delicate balancing act of preventing water loss while at the same time eliminating watersoluble mineral wastes. Many factors, such as prolonged dehydration or immobilization, can upset this balance. The balance also may be upset by underlying diseases, such as gout, hyperparathyroidism (disease caused by oversecretion of the parathyroid glands), Cushing syndrome, or urinary tract infections and neoplasms. A person may develop renal calculi because of an excessive intake of vitamin D or dietary calcium. The condition appears to be genetic for certain types of stones, with men much more commonly affected than women. In many instances, no specific cause can be pinpointed.

READ:   Kidney Stones

Location of calculi in the urinary tract

FIGURE. Location of calculi in the urinary tract.

Signs and Symptoms

A person having renal calculi may remain asymptomatic for long periods. If a stone or calculus fragment lodges in a ureter, however, the individual may complain of intense flank pain and urinary urgency. Classic ureteral colicky pain is manifested by acute, intermittent, and excruciating pain in the flank and upper outer quadrant of the abdomen on the affected side. If calculi are in the renal pelvis and calyces, the pain is duller and more constant. Back pain and severe abdominal pain may occur. Other presenting symptoms include nausea, vomiting, chills and fever, hematuria, and abdominal distention.

READ:   8 Signs and Symptoms of Kidney Stones

Diagnostic Procedures

The history may reveal a familial tendency toward the formation of kidney stones. A urinalysis may be ordered to detect elevated levels of RBCs or WBCs in the urine or to check for the presence of protein, pus, and bacteria. CT scan and abdominal x-ray (or KUB) may be ordered to determine the locations of calculus formation. A noncontrast spiral CT scan of the ureters and kidneys is the preferred test for kidney stones. In this test, the scanner moves in a circle as the client moves through the machine. This test takes less time than a standard CT scan and provides better images of the kidneys and ureters. Blood testing may be helpful in confirming imbalances of minerals or the existence of other metabolic disorders.

READ:   9 Ways to Prevent Kidney Stones


Treatment is directed at clearing obstructive stones and preventing the formation of new ones. Increased fluid intake (greater than 3 L/day) may enhance elimination of stones in some cases, but large stones may require surgical intervention, especially if renal function is threatened. Ureteroscopic removal with the use of fluoroscopic guidance may be used to dilate the ureter to grasp and remove the stone. Techniques such as ultrasonic percutaneous lithotripsy and extracorporeal shock wave lithotripsy pulverize stones in place, allowing them to be passed in the urine or removed by suction. Lithotripsy via a ureteroscope can also be used to remove urethral stones. Antibiotics may be prescribed if it is determined that the calculus buildup is due to bacterial infection. Analgesics may be necessary for the relief of intense pain.

READ:   8 Signs and Symptoms of Kidney Stones

Complementary Therapy

Complementary practitioners recommend drinking 8 or more glasses of water per day and eating a diet high in fiber and low in fat, with reduction of red meat consumption. Vitamins and minerals may be helpful especially when coordinated with the primary care provider. Relaxation techniques may be beneficial to deal with the pain.

Client communication

Stress the importance of proper diet and completing any medicinal therapy. Explain any diagnostic or surgical procedures to clients. Encourage increased fluid intake.


The prognosis is good if urinary tract obstruction is prevented and underlying disorders are promptly treated. However, about 60% of people who have a calcium stone have further stone formation later.

READ:   9 Ways to Prevent Kidney Stones


An adequate daily fluid intake is the best way to minimize the chance of stone formation, especially among individuals at risk. Fruit juices, especially unsweetened cranberry and blueberry juice, help acidify urine and may help prevent the formation of renal calculi.

Video: How Do Kidney Stones Form? How Can We Prevent Them?

8 Signs and Symptoms of Kidney Stones What are kidney stones? Kidney stones are hard collections of salt and minerals often made up of calcium or uric acid. They form inside the kidney and can travel to other parts of the urinary tract. Stones vary in size. Some are as small as the period at the end of this sentence — a fraction of an inch. Others can grow to a few inches across. Some kidney stones can become so large they take up the entire kidney. A kidney stone forms when too much of certain minerals in your body accumulate in your urine. When you aren’t well hydrated, your urine becomes more concentrated with higher levels of certain minerals. When mineral levels are higher, it’s more likely that a kidney stone will form. About 1 out of every 11 people in the United States will get a kidney stone. Stones are more common in men, people who are obese, and those who have diabetes Smaller kidney stones that remain in the kidney often don’t cause any symptoms. You might not notice anything is amiss until the ...
Kidney Stones What are kidney stones? Kidney stones, or renal calculi, are solid masses made of crystals. Kidney stones usually originate in your kidneys. However, they can develop anywhere along your urinary tract, which consists of these parts: kidneys ureters bladder urethra Kidney stones are one of the most painful medical conditions. The causes of kidney stones vary according to the type of stone. Types of kidney stones Not all kidney stones are made up of the same crystals. The different types of kidney stones include: Calcium Calcium stones are the most common. They’re often made of calcium oxalate (though they can consist of calcium phosphate or maleate). Eating fewer oxalate-rich foods can reduce your risk of developing this type of stone. High-oxalate foods include: potato chips peanuts chocolate beets spinach However, even though some kidney stones are made of calcium, getting enough calcium in your diet can prevent stones from forming. U...
9 Ways to Prevent Kidney Stones Kidney stone prevention Kidney stones are hard mineral deposits that form inside your kidneys. They cause excruciating pain when they pass through your urinary tract. Up to 12 percent of Americans are affected by kidney stones. And once you’ve had one kidney stone, you’re 50 percent more likely to get another within the next 10 years. There’s no one sure way to prevent kidney stones, especially if you have a family history of the condition. A combination of diet and lifestyle changes, as well as some medications, may help reduce your risk. How to prevent kidney stones naturally Making small adjustments to your current diet and nutrition plan may go a long way toward preventing kidney stones. 1. Stay hydrated Drinking more water is the best way to prevent kidney stones. If you don’t drink enough, your urine output will be low. Low urine output means your urine is more concentrated and less likely to dissolve urine salts that cause stones. Lemonade and orange juice ...