Summary
განსაზღვრება
ანამნეზი და გასინჯვა
ძირითადი დიაგნოსტიკური ფაქტორები
- acute, severe flank pain
სხვა დიაგნოსტიკური ფაქტორები
- previous episodes of nephrolithiasis
- nausea and vomiting
- urinary frequency/urgency
- hematuria
- testicular pain
- obesity
- family history of nephrolithiasis
- precipitant medications
- groin pain
- fever
- tachycardia
- hypotension
- costovertebral angle and ipsilateral flank tenderness
რისკფაქტორები
- dehydration
- high salt intake
- white ancestry
- male sex
- obesity and metabolic syndrome
- crystalluria
- gastrointestinal surgery
- occupational exposure to dehydration
- warm climate
- family history of nephrolithiasis
- precipitant medications
- dietary animal protein intake
- ascorbic acid supplementation
დიაგნოსტიკური კვლევები
1-ად შესაკვეთი გამოკვლევები
- urinalysis
- CBC and differential
- serum electrolytes, BUN, and creatinine
- urine pregnancy test
- noncontrast helical CT scan
- stone analysis
გასათვალისწინებელი კვლევები
- plain abdominal radiograph (KUB)
- renal ultrasound
- intravenous pyelogram (IVP)
- magnetic resonance imaging (MRI)
- 24-hour urine monitoring
- spot urine for cystine
ახალი ტესტები
- dual-energy CT
მკურნალობის ალგორითმი
acute renal colic nonpregnant
confirmed stone: no evidence of obstruction nonpregnant
confirmed stone: with evidence of obstruction nonpregnant
pregnant
following an acute episode nonpregnant
კონტრიბუტორები
ექსპერტი მრჩევლები
Russell Terry, MD
Assistant Professor of Urology
University of Florida College of Medicine
Gainesville
FL
გაფრთხილება:
RT declares that he has no competing interests.
მადლიერება
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 topic.
გაფრთხილება:
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.
რეცენზენტები
Robert Tompkins, MD
Associate Professor
Department of Family Medicine
University of Texas Health Science Center
Tyler
TX
გაფრთხილება:
RT declares that he has no competing interests.
Lynda Frassetto, MD
Associate Professor of Medicine
Division of Nephrology
University of California at San Francisco
CA
გაფრთხილება:
LF declares that she has no competing interests.
Irfan Moinuddin, MD
Assistant Professor
Chicago Medical School
Rosalind Franklin University
Lombard
IL
Disclosures
IM declares that he has no competing interests.
Nagaraja Rao, MBBS, ChM, FRCS
Consultant Urological Surgeon
Spire Manchester Hospital
Manchester
UK
Disclosures
NR declares no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
References
Key articles
Pearle MS, Goldfarb DS, Assimos DG, et al. Medical management of kidney stones: AUA guideline. J Urol. 2014 Aug;192(2):316-24.Full text Abstract
European Association of Urology. Urolithiasis. Apr 2024 [internet publication].Full text
Assimos D, Krambeck A, Miller NL, et al. Surgical management of stones: American Urological Association/Endourological Society Guideline. 2016 [internet publication].Full text
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Acute appendicitis
- Ectopic pregnancy
- Ovarian cyst
More DifferentialsGuidelines
- Urolithiasis
- Medical management of kidney stones
More GuidelinesPatient information
Kidney infection
Kidney stones
More Patient informationLog in or subscribe to access all of BMJ Best Practice
Use of this content is subject to our disclaimer