Last reviewed: November 2017
Last updated: November  2017

Summary

Definition

History and exam

Key diagnostic factors

  • acute, severe flank pain

Other diagnostic factors

  • previous episodes of nephrolithiasis
  • nausea and vomiting
  • urinary frequency/urgency
  • haematuria
  • testicular pain
  • obesity
  • family history
  • precipitant medications
  • groin pain
  • fever
  • tachycardia
  • hypotension
  • costovertebral angle and ipsilateral flank tenderness

Risk factors

  • high protein intake
  • high salt intake
  • white ancestry
  • male sex
  • dehydration
  • obesity
  • crystalluria
  • occupational exposure to dehydration
  • warm climate
  • family history
  • precipitant medications

Diagnostic investigations

1st investigations to order

  • urinalysis
  • FBC and differential
  • serum electrolytes, urea, and creatinine
  • urine pregnancy test
  • non-contrast helical CT scan
  • stone analysis
Full details

Investigations to consider

  • KUB
  • renal ultrasound
  • IVP
  • 24-hour urine monitoring
  • spot urine for cystine
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Assistant Professor

Department of Urology

University of Texas Southwestern Medical Center

Dallas

TX

Disclosures

JA is a member of the Scientific Advisory Board for Boston Scientific .

Associate Program Director

Endocrinology Fellowship Program

Associate Professor

University of Texas Southwestern Medical Center

Dallas

TX

Disclosures

NM has received a research grant from the US National Institutes of Health to study strategies to reduce recurrence of nephrolithiasis and reduce stent-associated pain.

Dr Jodi Antonelli and Dr Naim Maalouf would like to gratefully acknowledge Dr Brian Eisner, Dr Michael E. Lipkin, Dr Muhammad Iqbal, Dr Keith Xavier, and Dr Mantu Gupta, previous contributors to this monograph. BE has received fees for consulting from Boston Scientific, Olympus/Gyrus ACMI, PercSys, and The Ravine Group. MEL declares that he is a consultant for Boston Scientific Corporation. MI, KX, and MG declare that they have no competing interests.

Peer reviewers VIEW ALL

Associate Professor

Department of Family Medicine

University of Texas Health Science Center

Tyler

TX

Disclosures

RT declares that he has no competing interests.

Associate Professor of Medicine

Division of Nephrology

University of California at San Francisco

CA

Disclosures

LF declares that she has no competing interests.

Assistant Professor

Chicago Medical School

Rosalind Franklin University

Lombard

IL

Disclosures

IM declares that he has no competing interests.

Consultant Urological Surgeon

Spire Manchester Hospital

Manchester

UK

Disclosures

NR declares no competing interests.

Use of this content is subject to our disclaimer