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Urinary Calculi

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Urinary Calculi

Urinary calculi are stone-solid particles existing in the urinary system, mainly composed of calcium. It causes pain, vomiting, hematuria, nausea, and, probably, chills and fever due to secondary contagions. General risk factors include mostly disorders that increase urinary salt concentration, by either increased excretion of calcium or uric acid salts, or by decreased excretion. Hyperoxaluria being the major calcium disorder can be caused by excessive take of oxalate-containing foods (e.g. rhubarb, spinach, cocoa, pepper, nuts, tea), or by excess oxalate absorption due to various enteric diseases (e.g.  Bacterial overgrowth syndromes, chronic pancreatic or biliary disease). Other risk factors include excessive use of vitamin C, purine (found in proteins, commonly from fish, meat, and poultry); which may increase formation of oxalate calcium calculus.

Presence of high levels of white blood cells and blood calcium in the urinary system indicates availability of an infection, which in our case is urinary calculi. Mostly x-rays of urinary calculi look white due to high presence of calcium levels. Treatment of urinary calculi can be done by; use of analgesic or painkillers such as morphine, fentanyl, ketorolac, but persistent vomiting can be treated by use of antiemetic e.g. ondansetron 10 mg IV. Another way is by use of medical expulsive therapy whereby large calculi that haven’t passed in less than 6 or 8 weeks, automatically need to be removed. This is done depending on the size and location of the calculus. Technique used include shock wave lithotripsy, and, to be completely sure with the removal or for large calculi, endoscopic technique is used ,which involves flexible or rigid ureteroscopes and use of direct –vision removal. Lastly calculus can be removed by dissolution method. Whereby prolonged alkalinization of potassium citrate with urine. In conclusion, urinary calculi can be prevented by; drinking a lot of water, that’s 8 to 10 glasses a day, reduce animal protein, and taking low oxalate and fat diet.

REFERENCES

Spek, A., Strittmatter, F., Graser, A., Kufer, P., Stief, C., & Staehler, M. (2016). Dual energy can accurately differentiate uric acid-containing urinary calculi from calcium stones. World Journal of Urology34(9), 1297-1302.

Alatab, S., Pourmand, G., El Howairis, M. E. F., Buchholz, N., Najafi, I., Pourmand, M. R., … & Pourmand, N. (2016). NATIONAL PROFILES OF URINARY CALCULI (A COMPARISON BETWEEN DEVELOPING AND DEVELOPED WORLDS). Daudon, M., Jungers, P., Bazin, D., & Williams, J. C. (2018). Recurrence rates of urinary calculi according to stone composition and morphology. Urolithiasis46(5), 459-470.

 

 

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