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kidney stone

KIDNEY STONE

Stone in tract occur once urinary chemistry ends up in concentrations of stone salts that exceeds the limit of stability for that salt in resolution. This most frequently reflects excessive excretion of 1 or additional stone constituents,deficient restrictive activity in piddle,or simply a coffee volume piddle leading to too targeted piddle.

TYPES OF urinary organ STONE

1.CALCIUM salt STONE
   -More than seventieth
CALCIUM PHOSPHATE STONE acid STONE amino acid STONE
MAGNESIUM ammonia PHOSPHATE STONE OR TRIPLE PHOSPHATE STONE
BOTH amino acid AND STRUVITE STONE alternative RARE sorts ar organic compound,2,8-DIHYDROXY-ADENINE ,GYPSUM,AND salt
PREDISPOSING FACTORS FOR urinary organ STONE symptom
-most common risk issue for formation. Of Ca salt stone

-it is upset hupercaciuria

-it is advanced condition that reflects excessive viscus absorption of  dietory Ca ,excessive reabsorption of bone  and urinary organ Ca leak.
HYPEROXALURIA
-extreme huperoxaluria happens within the rare disease primary hyperoxaluria.

-less severe hyperoxaluria is seen in viscus malabsortion. HYPERURICOSURIA

-It is mostly a metabolic in origin ,though a diet high in meat will increase salt  excretion therefore promoting precipitation of acid.
URINARY PH
-pH is very important just in case of acid ,cystine,or phosphate stones

-acidic piddle favours formation of acid and amino acid  stone.
LOW piddle VOLUME
-about 100 percent of stone forming patients haven\'t any placeable risk issue apart from targeted piddle because of low piddle volume .
CLINICAL options OF urinary organ STONE
PAIN
-Pain is cramping,sharp,excruciating unsteady in intensity however not fully remitting.
pain related to nausea ,vomiting and sweating. pain extends from loin down the road of epithelial duct to groin with radiation to testes in men and labia majors or ovaries in ladies. loin pain could also be gift
LOIN TENDRENESS
is usually manifestation of associated infection
PALPABLE urinary organ
 once calculus has been barred .HEMATURIA
COMPLICATION
INFECTION
-pyelonephritis
-periureteritis
-cystitis IMPACTION AND OBSTRUCTION

-Mostly to happens at pelvi-uretric  junction or within the epithelial duct ,either at the amount wherever it crosses the common os vessels or wherever it\'s getting ready to enter the bladder.
STRINCTURE OF epithelial duct.
MALIGNANT modification
 -due to chronic irritation  of cavity by caliculi.
ANURIA
-from obstruction of each epithelial ducts or of solitory ureter and urinary organ.
MANAGEMENT
FLUID INTAKE
-fluid intake ought to be high to avoid periods once piddle is concerntrated,even in the dark
DIETARY Ca
-In patient with symptom a Ca intake of 800-1000 mg/day to cut back risk of bone deminerlisation.
-no dietary Ca restriction for symptom.
DIETARY PROTIEN 
In patient with symptom in whom excessive intake of animal macromolecule is suspected. recommendation less dietary macromolecule to cut back Ca excretion.
DIETARY atomic number 11
-it is a crucial determinant of Ca excretion  and in symptom ,sodium intake shouldn\'t be over two gm/day.
THIAZIDE DIURETICS
stimulate urinary organ Ca resorption and cut back urinary Ca exception.
DIETARY salt
-Patient with hyperoxaluria ought to restric intake of the salt.
ANTIBIOTICS

-If tract infection is suspected
ANTISPASMODICS
-Like tab cataspa tds ought to be impose for painALKALISER 
-for disorder like sweetener important.SURGERY 
 If stone is massive enough

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