- Loss of inhibitors of crystallization.
Specific factors contributing in stone formation:
- Hypercalciuria
- Hyperuricosuria
- Hypocitraturia
- Hyperoxaluria
- Cystinuria
- Xanthinuria
- Inflammatory bowel diseases
Clinical Manifestations of Renal Calculi:
Renal colic is the commonest presentation. Other manifestations
include incidental discovery (during routine X-ray), or may present by
complications (e.g. urinary tract obstruction, hematuria, or infection).
Investigations:
Not all investigations are indicated for every patient with renal
stone. The more recurrent and aggressive the stone disease, the more the
investigations needed.
The investigations include:
- Blood tests:
Serum creatinine (for kidney function), HCO 3 (for diagnosis of
metabolic acidosis and RTA), uric acid (for hyperuricaemia) and serum
calcium (for hypercalcaemia). In cases of hypercalcaemia, Vitamin D and
parathormone (PTH) levels should be determined.
