1 / 7

RENAL DISEASE: RENAL STONES AND UT OBSTRUCTION Pathophysiology of Disease: Chapter 16 (401-404)

RENAL DISEASE: RENAL STONES AND UT OBSTRUCTION Pathophysiology of Disease: Chapter 16 (401-404). Jack DeRuiter, PhD Dept of Pharmacal Sciences April, 2000. Urinary Tract Obstruction: Common Causes (page 402). Obstructions of Ureter, Bladder Outlet or Urethra caused by:

tyme
Download Presentation

RENAL DISEASE: RENAL STONES AND UT OBSTRUCTION Pathophysiology of Disease: Chapter 16 (401-404)

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. RENAL DISEASE:RENAL STONES AND UT OBSTRUCTIONPathophysiology of Disease: Chapter 16 (401-404) Jack DeRuiter, PhD Dept of Pharmacal Sciences April, 2000

  2. Urinary Tract Obstruction:Common Causes (page 402) Obstructions of Ureter, Bladder Outlet or Urethra caused by: • Structural malformations (Table 16-16) • Inflammation and Trauma • Tumor/Cancer of renal and neighboring structures • Blood clots • Pregnancy • Neuropathy/Spinal Cord Disease • Renal stones

  3. Clinical Presentation: (pages 401-404) • Flank Pain (+/-): • Distention of ureter, renal pelvis or capsule • Severity: proportional to distention • Hematuria • Azotemia: Bilateral Obstruction • Decreased urine production • Anuria: Bilateral obstruction

  4. Etiology (page 402) • Hypercalciuria (75%): Calcium oxalate stone • Heredity (Idiopathic; most common), Neoplasm, Bowel surgery • Struvite Stones (10-15%): Magnesium, Ammonium, Phosphate • UT Infections: Urease-Producing microbes (Proteus) • Hyperusicosuria (5-8%): Uric acid stones • Gout, Heredity, Malignancy, Lesch-Nyhan Syndrome • Cystinuria (1%): Defective amino acid transport

  5. Pathology and Pathogenesis (page 402) • Cause: Nucleation and precipitation of salts in renal structures • Contributing Factors • Dehydration: Less salt “dissolved” • High protein diets: Acidosis and Inc GFR: Ca • High sodium diet: Calcium oxalate • Essential Hypertension: Hypercalciuria • Dietary calcium and oxalate does not enhance likelihood of stone formation in most patients

  6. Preventative/Protective Measures (page 402) • Fluids: Enhanced dissolution of salts • Citrate: chelates Ca to form soluble complex which is excreted • Magnesium: Salt replacement? • Dietary fiber: Indirect Effect?

  7. Treatment and Complications:Pages 403-404 • Stone passage: Fluids, bed rest and analgesia • Treatments (Table 16-17): • Diuretics, urine alkalinization, allopurinol, etc • Complications: • Hydronephrosis/Complete obstruction • Infection or abscess behind obstruction • Renal damage due to repeated stone formation • Hypertension: increased renin production

More Related