22 September 2015

Paired retroperitoneal structures Filtration and excretion of metabolic waste products Regulation of electrolytes, fluid, and acid-base balance Stimulation of RBC production

Renal calculi A common cause of renal failure Supersaturation of the urine by stone-forming constituents Calcium, oxalate, and uric acid Dehydration, low fluid intake

Kidney stones can cause kidney damage in two primary ways An untreated obstructing stone that causes persistent severe blockage Infection related stones can lead to ongoing chronic urinary tract infections that cause damage slowly through inflammation and scarring of the kidney tissue

Pain Hematuria UTI Renal failure Asymptomatic

Urine examination Plain KUB BUN, Creatinine IVP CT scan

Conservative, medication ESWL ( extracorporeal shockwave lithotripsy ) RIRS ( retrograde intrarenal surgery ) PCNL ( percutaneous nephrolithotomy ) Open Sx ( Anatrophic nephrolithotomy, Pyelolithotomy ) Nephrectomy

Percutaneous nephrolithotomy PRS : Percutaneous Renal Surgery A minimally invasive technique to access the kidney to remove large stones (>2cm) or stones Small puncture wound

Blockage of the flow of urine out of the body Common cause of acute and chronic renal failure Intrinsic and extrinsic cause Urine stasis, infection, stone formation, anatomical changes, renal deterioration

Post-renal renal failure Supravesical obstruction (Bilateral ureteral obstruction) infravesical obstruction (Bladder outlet obstruction) Hydronephrosis Surgical anuria Overflow incontinence

Underlying diseases Previous renal function Signs of CKD LUTS History of KUB stone

CBC BUN, Cr., electrolyte UA Plain KUB Ultrasound

Hydronephrosis : a hallmark of urinary tract obstruction Measurement of kidney size and echogenicity as part of an evaluation of chronic kidney disease No exposure to radiation Interpretation is operator-dependent

Urinary diversion Foley catheter Intake, output monitoring Nephrotoxics avoidance Electrolyte imbalance

A surgical procedure that reroutes the normal flow of urine out of the body Urine cannot flow out of the body External diversion (nephrostomy) Internal diversion (double J stent)

A blockage at the base of the bladder that reduces or prevents the flow of urine BPH, Urethral stricture, Urethral calculi LUTS (lower urinary tract symptoms) Mechanical, Functional Foley catheter