Nephrolithiasis

Calcareous stones result from hypercalciuria, hyperoxaluria and hypocitraturia. Hypercalciuria and hyperoxaluria render urine supersaturated in respect of calcium salts; citrate makes calcium oxalate more soluble and inhibits its precipitation from solution.

Noncalcareous stones occur most commonly in the presence of urea-splitting organisms which create conditions in which magnesium ammonium phosphate (struvite) stones form. Urate stones form when urine is unusually acid (pH < 5.5).

Management. Recurrent stone-formers should maintain a urine output exceeding 2.51/d. Some benefit from restricting dietary calcium or reducing the intake of oxalate-rich foods (rhubarb, spinach, tea, chocolate, peanuts).

• Thiazide diuretics reduce the excretion of calcium and oxalate in the urine and reduce the rate of stone formation.

• Sodium cellulose phosphate (Calcisorb) binds calcium in the gut, reduces urinary calcium excretion and may benefit calcium stone-formers.

• Allopurinol is effective in those who have high excretion of uric acid in the urine.

• Potassium citrate, which alkalinises the urine, should be given to prevent formation of pure uric acid stones.

Blood Pressure Health

Blood Pressure Health

Your heart pumps blood throughout your body using a network of tubing called arteries and capillaries which return the blood back to your heart via your veins. Blood pressure is the force of the blood pushing against the walls of your arteries as your heart beats.Learn more...

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