The patient with acute renal problems
Peate Ian, Dutton Helen in Acute Nursing Care, 2020
These kidney stones are made up of calcium and other minerals found in urine and they can accumulate in the renal pelvis and calyces, leading to renal obstruction. Factors that predispose individuals to this problem include dehydration, excessive intake of vitamin D or calcium, high levels of uric acid and renal infection (Tortora et al. 2017). Small stones can pass through the ureters and urethra and be excreted in the urine, but larger stones can lead to obstruction of the ureters, especially as they may sometimes have jagged edges. When this happens, it leads to intense, stabbing pain called ‘renal colic’, where the muscles of the affected ureter rhythmically contract in an attempt to dislodge the stone. The pain often starts in the flank of the affected side and radiates into the groin, and it may be accompanied by other urinary tract symptoms, such as frequent urination or urge incontinence. If the stone cannot be moved, hydronephrosis may occur, which is when the kidney swells due to the obstructed flow of urine (Tortora et al. 2017).
The patient with acute renal problems
Ian Peate, Helen Dutton in Acute Nursing Care, 2014
These kidney stones are made up of calcium and other minerals found in urine and they can accumulate in the renal pelvis and calyces, leading to renal obstruction. Factors that predispose individuals to this problem include dehydration, excessive intake of vitamin D or calcium, high levels of uric acid and renal infection (Tortora et al. 2009). Small stones can pass through the ureters and urethra and be excreted in the urine, but larger stones can lead to obstruction of the ureters, especially as they may sometimes have jagged edges. When this happens it leads to intense, stabbing pain called ‘renal colic’, where the muscles of the affected ureter rhythmically contract in an attempt to dislodge the stone. The pain often starts in the flank of the affected side and radiates into the groin and it may be accompanied by other urinary tract symptoms such as frequent urination or urge incontinence. If the stone cannot be moved, hydronephrosis may occur, this is when the kidney swells due to the obstructed flow of urine (Thibodeau and Patton 2003).
Personalized Nutrition in Chronic Kidney Disease
Nilanjana Maulik in Personalized Nutrition as Medical Therapy for High-Risk Diseases, 2020
Interstitial diseases and recurrent kidney stones are often associated with subtle derangements in the complex metabolic machine of tubular reabsorption. While kidney function is often normal, these diseases are seen as forms of CKD (usually stages 1–2) because of alterations they produce in the electrolyte composition of blood or urine. Kidney stones are the most common symptom leading to diagnosis. Correcting a metabolic derangement is not simple or always feasible, and diet alone may not be sufficient; an extensive discussion of these complex alterations is beyond the scope of this review, but some suggestions regarding a pragmatic nutritional approach to kidney stones is reported in Table 9.5 (Gambaro, Croppi et al. 2016; Scales, Tasian et al. 2016).
A two-dimensional numerical study of peristaltic contractions in obstructed ureter flows
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2018
Z. Najafi, B. F. Schwartz, A. J. Chandy, A. M. Mahajan
The urinary system is primarily responsible for the elimination of waste products from the body and maintaining a balance of fluid or salt. In the urinary system, the kidneys remove the urea from blood and excrete it through the urethra. The flow of urine from the kidneys to the ureter is accomplished by peristaltic (pumping) contractions (Constantinou 1974). Peristaltic motion is a fundamental feature to many other physiological flows such as those in the esophagus and reproductive organs (Fung and Yih 1968; Misra and Pandey 2001; Fauci and Dillon 2006). It is defined as the fluid flow resulting from waves of contraction and expansion. The peristalsis of urine through the ureter can sometimes be accompanied by entities such as kidney stones or calculi. Kidney stones are accumulated mineral deposits that form in the kidney and drop into the ureter (Pak et al. 2003). In the kidney stone disease or urolithiasis, particles often get stuck and block the flow of urine, thereby causing severe pain.
Kidney stone proteomics: an update and perspectives
Published in Expert Review of Proteomics, 2021
Paleerath Peerapen, Visith Thongboonkerd
Kidney stone disease (alternatively, nephrolithiasis, or urolithiasis) is caused by the deposition of solid mass composed mainly of calcium oxalate (CaOx) crystals within the kidney or urinary tract. It remains a healthcare burden in several countries around globe with the increasing prevalence and incidence [1–4]. The additional main problem of this disease is its high recurrence rate after calculi removal [5]. Several previous studies had thus attempted to address pathophysiologic mechanisms of this disease aiming for improvement of the treatment and prevention. Urine and renal calculi were the important specimens for studying compositions and their relevant pathologic and etiologic roles in kidney stone disease [6,7]. Some molecules, either small chemical compounds or macromolecules (i.e. protein, glycosaminoglycans (GAGs)), had been identified in the urine and stone matrices and thought to be involved in the stone formation processes [6,7]. Several in vitro cellular studies using various cell lines had been performed to explore the underlying cellular mechanisms [8,9]. Additionally, the in vitro crystal assays had been introduced to further define the crystal modulatory activities of those molecules that might be associated with kidney stone formation [10–13]. However, the scale and scope of those earlier studies had been limited only to a small number of particular compounds or molecules of interest with some prior information.
Comparison of the effects of general, spinal and epidural anesthesia on ureter access and surgical outcomes during flexible ureterorenoscopy for transurethral single stone removal surgeries: a monocentric retrospective study
Published in Annals of Medicine, 2021
Haoliang Cai, Xiaohui Wu, Xi Chen, Wenting Chen
The study covers a topic that is normally not much studied in the urology field but there are several limitations of the study that have to be reported, for example, a monocentric retrospective analysis, and lack of prospective, randomized trial. ASA scores and ages are not homogeneous among groups and it can affect the results (patients enrolled in the GA group were younger and higher in numbers with ASA grade I than those of the SA and the EA groups. These may create bias). Even though the vasodilation property of levobupivacaine has been reported [26], the study did use bupivacaine for spinal anaesthesia. Different surgeons may have different preferences for perioperative patient management. In the parent and the referring hospitals, types of anaesthesia were not fixed even with the high incidence of kidney stones, and many kidney stones are usually treated with ureterorenoscopy. This was determined sometimes by surgeons and sometimes by anaesthesiologists. Also, the differences in dilatation time would be due to surgeons’ different clinical practices [27]. Significant data about the experience of operators (anaesthesiologists/urologists) for each study group are not discussed. General anaesthesia is superior because it took approximately one-half of a minute (30–40 s) less to reach the kidney stone. While this might be statistically significant with the high number of patients, but it is physiologically insignificant.
Related Knowledge Centers
- Calculus
- Dysuria
- Hematuria
- Hypercalciuria
- Renal Colic
- Ureter
- Urinary System
- Kidney
- Crystallopathy
- Genetics