Renal Calculus

Basics

1–15% lifetime risk in the general population
Twice as common in patients with family hx
Male:female 1–2.4:1
Peak incidence between 40 and 60 yr old
Theories on stone formation:
- Urinary supersaturation of solute followed by crystal precipitation
- Decrease in the normal urinary proteins inhibiting crystal growth
- Urinary stasis from a physical anomaly, catheter placement, neurogenic bladder, or the presence of a foreign body
Recurrence rate of 15% at 1 yr, 40% at 5 yr, 50% at 10 yr, and 75% at 20 yr
Associated with chronic kidney disease, hypertension, type 2 diabetes mellitus, metabolic syndrome, gout, gastric bypass procedures, short bowel syndrome, frequent UTIs, and an increased risk of coronary artery disease

Rare in children, but increasing in prevalence
When present, often is an indication of a metabolic or genetic disorder
60% present with flank or abdominal pain though up to 30% only present with hematuria
Pediatric patients <16 yr comprise ∼7% of all cases of renal stones
1:1 sex distribution
Causes of stone formation:
- Metabolic abnormalities (50–95%)
- Urologic abnormalities (20%)
- Infection (15%)
- Immobilization syndrome (5%)
Recurrence rate up 50% at 3 yr
All children affected should undergo a complete metabolic workup

There's more to see -- the rest of this topic is available only to subscribers.

All content is protected by copyright and may not be used for AI model training or other unauthorized purposes.