Urolithiasis (Kidney Stone)
Not yet clinically reviewed
This protocol was migrated from the earlier Pharmapedia and Ward Guide apps for educational use. Follow your hospital's own policies and consult seniors when in doubt.
Kidney stones (also called renal calculi, nephrolithiasis or urolithiasis) are hard deposits made of minerals and salts that form inside your kidneys. Diet, excess body weight, some medical conditions, and certain supplements and medications are among the many causes of kidney stones.
Clinical Features
- Sudden onset of acute colic, localized to the flank , causing the patient to move constantly.
- Nausea and vomiting referred pain to the scrotum or labium on the same side as the stone moves down the ureter.
Investigations
CBC, Urine analysis, X - ray KUB (except in pregnancy), Ultrasound KUB and CT KUB.
Management
- Ensure adequate hydration
- Manage acute urinary retention due to bladder or urethral stones by urethral catheterization or supra - pubic cystostomy respectively
- Kidney stones less than 8mm are usually managed conservatively as follow
- Cap - Rowatinex 1 cap PO x BD
- Tab / Inj – Diclofenac (Voren) 50 / 75mg PO / IMX SOS
- Tab Drotaverine (Nospa) IV x stat then SOS
- Tab- Ciprofloxacin (Novidat) 500mg 1 tab PO x BD for 5 days
- Syp Citric acid (Citralka ) 2 TSF dissolved in a glass of water PO TDS
- Tab – Tamsulosin (Tamsol ) 0.4 mg 1 tab PO x OD at night
- Other alternatives particularly for stones of larges sizes include wave lithotripsy , and uteroscopy, extracorporeal shock percutaneous nephrostomy, and surgical removal of stones Better to refer to urologist if the stone size is greater than 6 mm.