Materiały źródłowe

• #1 Kidney stones – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/kidney-stones/diagnosis-treatment/drc-20355759

  Diagnosis involves the steps that your healthcare professional takes to find out if you have kidney stones. Diagnosis also can include testing to find the cause and chemical makeup of kidney stones. Your healthcare professional starts by giving you a physical exam. You also may need tests such as: […] Blood tests may reveal too much calcium or uric acid in your blood. Blood test results help track the health of your kidneys. These results also may lead your healthcare professional to check for other health conditions. […] Your healthcare professional may ask you to collect samples of your urine over 24 hours. The 24-hour urine collection test may show that your body is releasing too many stone-forming minerals or too few substances that prevent stones. […] Imaging tests such as CT scans may show kidney stones in your urinary tract. An advanced scan known as a high-speed or dual energy CT scan may help find tiny uric acid stones.

• #1 Kidney stones in adults: Diagnosis and acute management of suspected nephrolithiasis – UpToDate

  https://www.uptodate.com/contents/kidney-stones-in-adults-diagnosis-and-acute-management-of-suspected-nephrolithiasis

  Kidney stones in adults: Diagnosis and acute management of suspected nephrolithiasis […] Kidney stone disease (nephrolithiasis) is a common problem in primary care practice. Patients may present with the classic symptoms of renal colic and hematuria. Others may be asymptomatic or have atypical symptoms such as vague abdominal pain, acute abdominal or flank pain, nausea, urinary urgency or frequency, difficulty urinating, penile pain, or testicular pain. […] Primary care clinicians need to be alert to the possibility of nephrolithiasis and its consequences to decide upon a diagnostic approach, therapy, and the need for referral to a urologist. […] Evaluation of suspected nephrolithiasis includes laboratory testing and diagnostic imaging. […] Selection of modality for diagnostic imaging is crucial, with noncontrast CT being a common choice. […] Ultrasound of the kidneys and bladder is also utilized, along with less frequently used tests such as abdominal radiography, intravenous pyelography, and magnetic resonance imaging.

• #2 Diagnosis of Kidney Stones – NIDDK

  https://www.niddk.nih.gov/health-information/urologic-diseases/kidney-stones/diagnosis

  Health care professionals use your medical history, a physical exam, and lab and imaging tests to diagnose kidney stones. […] Health care professionals may use lab or imaging tests to diagnose kidney stones. […] Urine tests can show whether your urine contains high levels of minerals that form kidney stones. Urine and blood tests can also help a health care professional find out what type of kidney stones you have. […] A health care professional may take a blood sample from you and send the sample to a lab to test. The blood test can show if you have high levels of certain minerals in your blood that can lead to kidney stones. […] Health care professionals use imaging tests to find kidney stones. […] Abdominal x-rays can show the location of kidney stones in the urinary tract. Not all stones are visible on abdominal x-ray. […] CT scans can show the size and location of a kidney stone, if the stone is blocking the urinary tract, and conditions that may have caused the kidney stone to form.

• #2 Diagnosis and Initial Management of Kidney Stones | AAFP

  https://www.aafp.org/pubs/afp/issues/2001/0401/p1329.html

  The diagnosis and initial management of urolithiasis have undergone considerable evolution in recent years. The application of noncontrast helical computed tomography (CT) in patients with suspected renal colic is one major advance. The superior sensitivity and specificity of helical CT allow urolithiasis to be diagnosed or excluded definitively and expeditiously without the potential harmful effects of contrast media. […] Physicians can now conclusively identify and, perhaps more importantly, exclude stone disease within minutes of considering the diagnosis. […] The diagnosis of urinary tract calculi begins with a focused history. Key elements include past or family history of calculi, duration and evolution of symptoms, and signs or symptoms of sepsis. […] Urinalysis should be performed in all patients with suspected calculi.

• #3 Kidney stone disease – Wikipedia

  https://en.wikipedia.org/wiki/Kidney_stone_disease

  The diagnosis is usually made on the basis of the location and severity of the pain, which is typically colicky in nature (comes and goes in spasmodic waves). Pain in the back occurs when calculi produce an obstruction in the kidney. […] A computed tomography (CT) scan is also not typically recommended in children. […] Otherwise a noncontrast helical CT scan with 5 millimeters (0.2 in) sections is the diagnostic method to use to detect kidney stones and confirm the diagnosis of kidney stone disease. […] Where a CT scan is unavailable, an intravenous pyelogram may be performed to help confirm the diagnosis of urolithiasis. […] Renal ultrasonography can sometimes be useful, because it gives details about the presence of hydronephrosis, suggesting that the stone is blocking the outflow of urine.

• #4 Nephrolithiasis – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/225

  Nephrolithiasis (kidney stones) is a common condition, typically affecting adult men more commonly than adult women, although this difference is narrowing. […] Non-contrast computed tomography scan of the abdomen/pelvis is the imaging modality with the highest sensitivity and specificity to diagnose stones. Plain x-ray (KUB) and renal ultrasound can be utilized for diagnosis in some cases, such as a desire to reduce or eliminate radiation exposure. […] 24-hour urine tests are recommended for most stone formers to determine the cause of stone formation and optimal treatment to help prevent future stone episodes. […] Key diagnostic factors include acute, severe flank pain. […] Other diagnostic factors include previous episodes of nephrolithiasis, nausea and vomiting, urinary frequency/urgency, hematuria, testicular pain, obesity, family history of nephrolithiasis, precipitant medications, groin pain, fever, tachycardia, hypotension, and costovertebral angle and ipsilateral flank tenderness.

• #5 Diagnosis of Kidney Stones – NIDDK

  https://www.niddk.nih.gov/health-information/urologic-diseases/kidney-stones/diagnosis

  Health care professionals use your medical history, a physical exam, and lab and imaging tests to diagnose kidney stones. […] Health care professionals may use lab or imaging tests to diagnose kidney stones. […] Urine tests can show whether your urine contains high levels of minerals that form kidney stones. Urine and blood tests can also help a health care professional find out what type of kidney stones you have. […] A health care professional may take a blood sample from you and send the sample to a lab to test. The blood test can show if you have high levels of certain minerals in your blood that can lead to kidney stones. […] Health care professionals use imaging tests to find kidney stones. […] Abdominal x-rays can show the location of kidney stones in the urinary tract. Not all stones are visible on abdominal x-ray. […] CT scans can show the size and location of a kidney stone, if the stone is blocking the urinary tract, and conditions that may have caused the kidney stone to form.

• #6 Kidney Stones: Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/15604-kidney-stones

  Kidney stones can be diagnosed using imaging, blood and urine tests. If your provider suspects you have a kidney stone based on your symptoms and physical exam, you may need one or more of these tests: […] A provider can test your pee for blood, stone-forming crystals and signs of infection. […] X-rays, CT scans (computed tomography scans) and ultrasound can help your healthcare provider see the size, shape, location and number of stones. […] A provider can use blood tests to check your kidney function, detect infections and look for high levels of calcium or other conditions that could lead to stone formation.

• #7 Nephrolithiasis Workup: Approach Considerations, Urinalysis, Blood Studies

  https://emedicine.medscape.com/article/437096-workup

  The 2023 EAU guideline recommends ultrasound for initial assessment when there is concern for an acute symptomatic stone, followed by noncontrast-enhanced computed tomography to confirm stone diagnosis. […] Microscopic examination of the urine for evidence of hematuria and infection is a critical part of the evaluation of a patient thought to have renal colic. […] Degree of hematuria is not predictive of stone size or likelihood of passage. […] Measurements of serum electrolyte, creatinine, calcium, uric acid, parathyroid hormone (PTH), and phosphorus are needed to assess a patients current renal function and to begin the assessment of metabolic risk for future stone formation. […] To identify urinary risk factors, a 24-hour urine profile, including appropriate serum tests of renal function, uric acid, and calcium, is needed.

• #8 Kidney Stones: Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/15604-kidney-stones

  Kidney stones can be diagnosed using imaging, blood and urine tests. If your provider suspects you have a kidney stone based on your symptoms and physical exam, you may need one or more of these tests: […] A provider can test your pee for blood, stone-forming crystals and signs of infection. […] X-rays, CT scans (computed tomography scans) and ultrasound can help your healthcare provider see the size, shape, location and number of stones. […] A provider can use blood tests to check your kidney function, detect infections and look for high levels of calcium or other conditions that could lead to stone formation.

• #9 Kidney Stones: Treatment and Prevention | AAFP

  https://www.aafp.org/pubs/afp/issues/2019/0415/p490.html

  Kidney stones are a common disorder, with an annual incidence of eight cases per 1,000 adults. […] The diagnostic workup consists of urinalysis, urine culture, and imaging to confirm the diagnosis and assess for conditions requiring active stone removal, such as urinary infection or a stone larger than 10 mm. […] All patients with kidney stones should be screened for risk of stone recurrence with medical history, basic laboratory evaluation, and imaging. […] The initial workup of a patient with suspected kidney stones in the primary care setting should include point-of-care urinalysis to detect blood, because hematuria helps confirm the diagnosis. […] When immediate referral is not indicated, urine culture and urinalysis (if not already done) should be ordered to rule out infection, as well as imaging to confirm the diagnosis of kidney stones and assess for hydronephrosis and stone size and position.

• #10 Nephrolithiasis Workup: Approach Considerations, Urinalysis, Blood Studies

  https://emedicine.medscape.com/article/437096-workup

  Acute renal colic with resultant flank pain is a common and sometimes complex clinical problem. Whereas noncontrast abdominopelvic computed tomography (CT) scans have become the imaging modality of choice, in some situations, renal ultrasonography or a contrast study such as intravenous pyelography (IVP) may be preferred. […] Most authors recommend diagnostic imaging to confirm the diagnosis in first-time episodes of ureterolithiasis, when the diagnosis is unclear, or if associated proximal urinary tract infection (UTI) is suspected. […] Guidelines from the European Association of Urology (EAU) recommend the following laboratory tests in all patients with an acute stone episode: Urinary sediment/dipstick test for demonstration of blood cells, with a test for bacteriuria (nitrite), urinary pH, and urine culture in case of a positive reaction; Serum creatinine level, as a measure of kidney function; Serum uric acid, (ionized) calcium, sodium, and potassium; Complete blood cell count (CBC); C-reactive protein (CRP); Coagulation testing, if intervention is likely or planned: Activated partial thromboplastin time (aPTT) and prothrombin time (PT) with International Normalized ratio (INR).

• #11 Kidney stones – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/kidney-stones/diagnosis-treatment/drc-20355759

  Diagnosis involves the steps that your healthcare professional takes to find out if you have kidney stones. Diagnosis also can include testing to find the cause and chemical makeup of kidney stones. Your healthcare professional starts by giving you a physical exam. You also may need tests such as: […] Blood tests may reveal too much calcium or uric acid in your blood. Blood test results help track the health of your kidneys. These results also may lead your healthcare professional to check for other health conditions. […] Your healthcare professional may ask you to collect samples of your urine over 24 hours. The 24-hour urine collection test may show that your body is releasing too many stone-forming minerals or too few substances that prevent stones. […] Imaging tests such as CT scans may show kidney stones in your urinary tract. An advanced scan known as a high-speed or dual energy CT scan may help find tiny uric acid stones.

• #12 Kidney Stones: Medical Mangement Guideline – American Urological Association

  https://www.auanet.org/guidelines-and-quality/guidelines/kidney-stones-medical-mangement-guideline

  When a stone is available, clinicians should obtain a stone analysis at least once. (Clinical Principle) […] Clinicians should obtain or review available imaging studies to quantify stone burden. (Clinical Principle) […] Clinicians should perform additional metabolic testing in high-risk or interested first-time stone formers and recurrent stone formers. (Standard; Evidence Strength: Grade B) […] Clinicians should recommend to all stone formers a fluid intake that will achieve a urine volume of at least 2.5 liters daily. (Standard; Evidence Strength: Grade B) […] Clinicians should offer thiazide diuretics to patients with high or relatively high urine calcium and recurrent calcium stones. (Standard; Evidence Strength Grade B) […] Clinicians should offer potassium citrate therapy to patients with recurrent calcium stones and low or relatively low urinary citrate. (Standard; Evidence Strength Grade B)

• #13 Diagnosis of Kidney Stones – NIDDK

  https://www.niddk.nih.gov/health-information/urologic-diseases/kidney-stones/diagnosis

  Health care professionals use your medical history, a physical exam, and lab and imaging tests to diagnose kidney stones. […] Health care professionals may use lab or imaging tests to diagnose kidney stones. […] Urine tests can show whether your urine contains high levels of minerals that form kidney stones. Urine and blood tests can also help a health care professional find out what type of kidney stones you have. […] A health care professional may take a blood sample from you and send the sample to a lab to test. The blood test can show if you have high levels of certain minerals in your blood that can lead to kidney stones. […] Health care professionals use imaging tests to find kidney stones. […] Abdominal x-rays can show the location of kidney stones in the urinary tract. Not all stones are visible on abdominal x-ray. […] CT scans can show the size and location of a kidney stone, if the stone is blocking the urinary tract, and conditions that may have caused the kidney stone to form.

• #14 Kidney Stones: Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/15604-kidney-stones

  Kidney stones can be diagnosed using imaging, blood and urine tests. If your provider suspects you have a kidney stone based on your symptoms and physical exam, you may need one or more of these tests: […] A provider can test your pee for blood, stone-forming crystals and signs of infection. […] X-rays, CT scans (computed tomography scans) and ultrasound can help your healthcare provider see the size, shape, location and number of stones. […] A provider can use blood tests to check your kidney function, detect infections and look for high levels of calcium or other conditions that could lead to stone formation.

• #15 Nephrolithiasis Workup: Approach Considerations, Urinalysis, Blood Studies

  https://emedicine.medscape.com/article/437096-workup

  Acute renal colic with resultant flank pain is a common and sometimes complex clinical problem. Whereas noncontrast abdominopelvic computed tomography (CT) scans have become the imaging modality of choice, in some situations, renal ultrasonography or a contrast study such as intravenous pyelography (IVP) may be preferred. […] Most authors recommend diagnostic imaging to confirm the diagnosis in first-time episodes of ureterolithiasis, when the diagnosis is unclear, or if associated proximal urinary tract infection (UTI) is suspected. […] Guidelines from the European Association of Urology (EAU) recommend the following laboratory tests in all patients with an acute stone episode: Urinary sediment/dipstick test for demonstration of blood cells, with a test for bacteriuria (nitrite), urinary pH, and urine culture in case of a positive reaction; Serum creatinine level, as a measure of kidney function; Serum uric acid, (ionized) calcium, sodium, and potassium; Complete blood cell count (CBC); C-reactive protein (CRP); Coagulation testing, if intervention is likely or planned: Activated partial thromboplastin time (aPTT) and prothrombin time (PT) with International Normalized ratio (INR).

• #16 Kidney Stones: Diagnosis, Work Up and Management – The ObG Project

  https://www.obgproject.com/2021/05/09/kidney-stones-diagnosis-work-up-and-management/

  CBC […] Creatinine […] The most important key to managing patient with nephrolithiasis is determining whether urgent intervention is needed. […] Repeat imaging after 2 weeks to assess stone position and look for hydronephrosis. […] Referral to urology if no improvement after 2 to 4 weeks. […] Urgent intervention required for the following: […] Obstructed upper urinary tract with infection/sepsis […] Pain refractory to analgesics […] Anuria […] Impending renal deterioration (abnormal creatinine) […] Intractable nausea and vomiting […] Solitary kidney […] Hemodynamic instability […] Patient preference […] false

• #17 Diagnosing Kidney Stones | NYU Langone Health

  https://nyulangone.org/conditions/kidney-stones/diagnosis

  Kidney stones are common: Nearly one in 10 Americans is diagnosed with one at some point. Without treatment and preventive efforts, half of all people who have been treated for one or more kidney stones develop another within five to 10 years. […] Your doctor conducts an initial physical exam and may order several tests, including blood and urine tests and imaging exams, to determine whether you have kidney stones and to diagnose the particular type and location. […] During your initial exam, your doctor may collect a small amount of blood in order to assess your kidney function, look for signs of infection, and test for factors that can contribute to the formation of kidney stones, such as high calcium levels, parathyroid hormone, and uric acid. […] Your doctor may analyze a sample of your urine in order to check for crystals, which can lead to the formation of kidney stones, and order a urine culture to determine if you have a urinary tract infection.

• #18

  https://www.nhs.uk/conditions/kidney-stones/diagnosis/

  Your GP will usually be able to diagnose kidney stones from your symptoms and medical history. […] You may be given tests, including: urine tests to check for infections and pieces of stones, an examination of any stones that you pass in your pee, blood tests to check that your kidneys are working properly and also check the levels of substances that could cause kidney stones, such as calcium. […] Having a kidney stone to analyse will make a diagnosis easier, and may help your GP determine which treatment method will be of most benefit to you. […] If you have severe pain that could be caused by kidney stones, your GP should refer you to hospital for an urgent scan: adults should be offered a CT scan, pregnant women should be offered an ultrasound scan, children and young people under 16 should be offered an ultrasound if the ultrasound does not find anything, a low-dose non-contrast CT scan may be considered.

• #19 Kidney Stones: Medical Mangement Guideline – American Urological Association

  https://www.auanet.org/guidelines-and-quality/guidelines/kidney-stones-medical-mangement-guideline

  The purpose of the clinical guideline on Medical Management of Kidney Stones is to provide a clinical framework for the diagnosis, prevention and follow-up of adult patients with kidney stones based on the best available published literature. […] The purpose of this guideline is to provide a clinical framework for the diagnosis, prevention and follow-up of adult patients with kidney stones based on the best available published literature. […] A clinician should perform a screening evaluation consisting of a detailed medical and dietary history, serum chemistries and urinalysis on a patient newly diagnosed with kidney or ureteral stones. (Clinical Principle) […] Clinicians should obtain serum intact parathyroid hormone (PTH) level as part of the screening evaluation if primary hyperparathyroidism is suspected. (Clinical Principle)

• #20 Diagnosis of Kidney Stones – NIDDK

  https://www.niddk.nih.gov/health-information/urologic-diseases/kidney-stones/diagnosis

  Health care professionals use your medical history, a physical exam, and lab and imaging tests to diagnose kidney stones. […] Health care professionals may use lab or imaging tests to diagnose kidney stones. […] Urine tests can show whether your urine contains high levels of minerals that form kidney stones. Urine and blood tests can also help a health care professional find out what type of kidney stones you have. […] A health care professional may take a blood sample from you and send the sample to a lab to test. The blood test can show if you have high levels of certain minerals in your blood that can lead to kidney stones. […] Health care professionals use imaging tests to find kidney stones. […] Abdominal x-rays can show the location of kidney stones in the urinary tract. Not all stones are visible on abdominal x-ray. […] CT scans can show the size and location of a kidney stone, if the stone is blocking the urinary tract, and conditions that may have caused the kidney stone to form.

• #21 Kidney Stones | Bladder Stones – Diagnosis, Evaluation and Treatment

  https://www.radiologyinfo.org/en/info/stones-renal

  Your doctor may use abdominal and pelvic CT, intravenous pyelogram, or abdominal or pelvic ultrasound to help diagnose your condition. […] Imaging is used to provide your doctor with valuable information about the kidney or bladder stones, such as location, size and effect on the function of the kidneys. Some types of imaging that your doctor may order include: […] Abdominal and pelvic CT: This is the most rapid scanning method for locating a stone. This procedure can provide detailed images of the kidneys, ureters, bladder and urethra, identify a stone and reveal whether it is blocking urinary flow. […] Intravenous pyelogram (IVP): This is an x-ray examination of the kidneys, ureters and urinary bladder that uses iodinated contrast material injected into veins to evaluate the urinary system. […] Abdominal and Pelvic ultrasound: These exams use sound waves to provide pictures of the kidneys and bladder and can identify blockage of urinary flow and help identify stones.

• #22 Diagnosis and Initial Management of Kidney Stones | AAFP

  https://www.aafp.org/pubs/afp/issues/2001/0401/p1329.html

  Diagnostic imaging is essential to confirm or exclude the presence of urinary calculi. Several imaging modalities are available, and each has advantages and limitations. […] Noncontrast helical CT is being used increasingly in the initial assessment of renal colic. This imaging modality is fast and accurate, and it readily identifies all stone types in all locations. Its sensitivity (95 to 100 percent) and specificity (94 to 96 percent) suggest that it may definitively exclude stones in patients with abdominal pain. […] Noncontrast helical CT may become the imaging technique of choice and the standard of care. Its emergence as the definitive initial imaging modality for urolithiasis may allow intravenous pyelography to be reserved for therapeutic planning in complex stone cases.

• #23 Kidney Stone Symptoms & Diagnosis – Kidney Stones & Urinary Obstruction | UCLA Health

  https://www.uclahealth.org/medical-services/urology/kidney-stone/kidney-stone-symptoms-diagnosis

  Diagnosing a kidney stone requires a physical exam and a medical history to be taken by a physician. […] Typically a urinalysis (testing of a urine sample), an abdominal x-ray, a computerized tomography (CT) scan, or an ultrasound will be done to complete the diagnosis. […] According to the American Urological Association, the current gold standard for confirming kidney stones is a non-contrast CT of the abdomen and pelvis. […] Once a stone is detected, size and location are established and are key determinants in the best management and treatment options.

• #24 Nephrolithiasis Workup: Approach Considerations, Urinalysis, Blood Studies

  https://emedicine.medscape.com/article/437096-workup

  Renal ultrasonography by itself is frequently adequate to determine the presence of a renal stone. […] Before the advent of helical CT, IVP, also known as intravenous urography (IVU), was the test of choice in diagnosing ureterolithiasis. […] The main advantage of IVP is the clear outline of the entire urinary system that it provides, making visualization of even mild hydronephrosis relatively easy. […] CT scanning has replaced IVP, the historic criterion standard, for the assessment of urinary tract stone disease, especially for acute renal colic. […] A renal colic study consists of a noncontrast or unenhanced CT scan of the abdomen and pelvis, including very narrow cuts taken through the kidneys and bladder areas, where symptomatic stones are most likely to be encountered. […] In current clinical practice, the renal colic noncontrast CT scan is the standard of care in most EDs when a patient is thought to have renal colic or presents with acute flank pain.

• #25 Nephrolithiasis – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/225

  1st tests to order include urinalysis, CBC and differential, serum electrolytes, BUN, and creatinine, urine pregnancy test, noncontrast helical CT scan, and stone analysis. […] Tests to consider include plain abdominal radiograph (KUB), renal ultrasound, intravenous pyelogram (IVP), magnetic resonance imaging (MRI), 24-hour urine monitoring, and spot urine for cystine. […] Emerging tests include dual-energy CT.

• #26

• #27 Kidney Stones: Treatment and Prevention | AAFP

  https://www.aafp.org/pubs/afp/issues/2019/0415/p490.html

  Although noncontrast-enhanced computed tomography (CT) of the abdomen and pelvis has superior sensitivity and specificity and is commonly performed in the emergency department, first-line ultrasonography has acceptable performance and is more cost-effective. […] Referral to a urologist for active stone removal is warranted when the stone is larger than 10 mm or if significant hydronephrosis is present. […] Patients with newly diagnosed kidney stones should receive a basic evaluation consisting of a detailed medical history, serum chemistry, and urinalysis/urine culture. […] The patient should be instructed to strain his or her urine to catch the stone, then send the stone in a urine specimen cup or a clean, dry container for analysis; noncalcium oxalate stones require additional metabolic testing. […] When stone analysis is not available, ultrasonography should be ordered to look for renal abnormalities if it was not performed before the stone was passed.

• #28 Expert discusses diagnosis of kidney stones in children

  https://www.urologytimes.com/view/expert-discusses-diagnosis-of-kidney-stones-in-children

  „Kidney stones can be diagnosed basically in 2 different ways. One is what we call an incidental finding on an x ray or an ultrasound. This is somebody who just happens to get an ultrasound or maybe a CT scan, and the radiologist identifies a kidney stone. And these children typically don’t have any symptoms. They may have some underlying issue that caused the stone, and this is the first time they have become aware of it. Of the other category of people, and particularly children who are diagnosed with kidney stones, are those who actually do present with symptoms, the ones that we discussed previously, such as flank pain, nausea, vomiting, gross hematuria, things like that. […] The mainstay of radiological imaging in the initial acute stone period is really ultrasound. And that’s very different from adult patients, where everybody pretty much just gets a CT scan to diagnose them. With the ultrasound, what we do is really look for hydronephrosis or swelling of the kidney. And that, in combination with symptoms like flank pain, vomiting, etc, is almost diagnostic of a kidney stone.

• #29

  https://www.birminghamurology.co.uk/newpage1

  Symptoms and diagnosis of kidney stones […] What tests are carried out to diagnose kidney stones? Initially a urine dipstick test will be performed to check for blood in the urine and rule out urine infection. Blood tests for kidney function and Calcium are performed. The definitive diagnostic test for stone is a plain CT scan of the Abdomen (CT Kidney Ureter Bladder area or CT KUB). This will show the size and position of stones which will help in planning treatment. […] If you are pregnant, you may need an Ultrasound scan or MRI scan for diagnosis.

• #30 Kidney Stones | Types, Causes, Symptoms, Diagnosis & Treatment

  https://www.cincinnatichildrens.org/health/k/kidney-stones

  Kidney stones are often diagnosed in the Emergency Department, when children come in with severe belly or side pain. The following may be used to diagnose and locate stones: […] Medical history […] Physical examination […] Renal ultrasound: the most common radiologic test used to diagnose a urinary tract stone. The technician slides a hand-held device (transducer) across the child’s skin. This is a painless test using sound waves to take pictures of the kidneys, ureters and bladder. The images created may show the location of the stone(s). […] CT scan: the child lies flat on a bed that slides into a doughnut-shaped device. 3D pictures help to determine the location of the kidney stone. […] Kidney, ureter, bladder (KUB) X-ray: A quick, simple X-ray takes a picture of the child’s abdomen, which identifies some types of kidney stones.

• #31 Kidney Stones Symptoms, Diagnosis, & Treatment – Urologists

  https://wisconsinurology.com/our-services/men-women/kidney-stones/

  Stones in the urinary system, also known as urolithiasis, are formations of deposits that form in the tubes that excrete urine from the body. […] Depending on the situation, our urologist may do a stone or urine analysis to better understand the type of stone your body is forming and come up with effective ways to prevent them from reoccurring. […] Urine analysis is often the first test done to exam the urine for blood, signs of infections, and other possible indicators for kidney stones. […] CT scans are the best test to diagnosis stones. CT scans are able to estimate the size of the stone and give exact location. This information helps decide what interventions should be implemented. […] Ultrasound is used to assess the kidney for fluid/hydronephrosis and monitor the kidneys once the stone has been expelled from the body. […] X-rays may be used in certain situations especially when monitoring the stone. It is important to note that X-rays only show calcium or struvite stones. X-rays have less radiation than CT scans which is why our urologist may use them to monitor a stone instead of repetitive CT scans.

• #32 Diagnosis Process | Kidney Stones | Urological Care

  https://www.urologyofva.net/urological-conditions/kidney-stones/kidney-stones-diagnosis/

  The best available test is a CAT scan of the abdomen and pelvis. Almost all stones appear very white on a non-contrast CAT scan, so they are generally easy to find when they overlie the grey areas of the kidneys or ureters. The CAT scan also allows the doctors to take measurements on stone size, location, and density all of which helps guide the decision about how to best manage the stone. […] An IVP (intravenous pyelogram) is another test that can diagnose most stones. It is less commonly used nowadays because it does not have the precision of a CAT scan, and it involves the injection of intravenous contrast to light up the kidneys. […] A renal ultrasound might show a kidney stone and kidney obstruction, but the ultrasound can miss a ureteral stone. […] The urinalysis may show blood in the urine and occasionally the presence of an infection. Blood work may show impairment of kidney function.

• #33 Diagnosis of Kidney Stones – NIDDK

  https://www.niddk.nih.gov/health-information/urologic-diseases/kidney-stones/diagnosis

  Health care professionals use your medical history, a physical exam, and lab and imaging tests to diagnose kidney stones. […] Health care professionals may use lab or imaging tests to diagnose kidney stones. […] Urine tests can show whether your urine contains high levels of minerals that form kidney stones. Urine and blood tests can also help a health care professional find out what type of kidney stones you have. […] A health care professional may take a blood sample from you and send the sample to a lab to test. The blood test can show if you have high levels of certain minerals in your blood that can lead to kidney stones. […] Health care professionals use imaging tests to find kidney stones. […] Abdominal x-rays can show the location of kidney stones in the urinary tract. Not all stones are visible on abdominal x-ray. […] CT scans can show the size and location of a kidney stone, if the stone is blocking the urinary tract, and conditions that may have caused the kidney stone to form.

• #34 Nephrolithiasis Workup: Approach Considerations, Urinalysis, Blood Studies

  https://emedicine.medscape.com/article/437096-workup

  The following are objective indications for a metabolic evaluation with a 24-hour urinalysis: Residual calculi after surgical treatment; Initial presentation with multiple calculi; Initial presentation before age 30 years; Renal failure; Solitary kidney (including renal transplant); Family history of calculi; More than 1 stone in the past year; Bilateral calculi. […] The most common findings on 24-hour urine studies include hypercalciuria, hyperoxaluria, hyperuricosuria, hypocitraturia, and low urinary volume. […] A urine pH greater than 7 suggests presence of urea-splitting organisms, such as Proteus, Pseudomonas, or Klebsiella species, and struvite stones. A urine pH less than 5 suggests uric acid stones. […] Plain abdominal radiography (also referred to as flat plate or KUB radiography) is useful for assessing total stone burden, as well as the size, shape, composition, and location of urinary calculi in some patients.

• #35 Kidney stones – Symptoms, causes, types, and treatment | National Kidney Foundation

  https://www.kidney.org/kidney-topics/kidney-stones

  Diagnosis of a kidney stone starts with a medical history, physical examination, and imaging tests. Your doctors will want to know the exact size and shape of the kidney stones. This can be done with a high resolution CT scan from the kidneys down to the bladder or an x-ray called a „KUB x-ray” (kidney-ureter-bladder x-ray) which will show the size of the stone and its position. The KUB x-ray is often obtained by the surgeons to determine if the stone is suitable for shock wave treatment. The KUB test may be used to monitor your stone before and after treatment, but the CT scan is usually preferred for diagnosis. In some people, doctors will also order an intravenous pyelogram or lVP, a special type of X-ray of the urinary system that is taken after injecting a dye. […] Second, your doctors will decide how to treat your stone. The health of your kidneys will be evaluated by blood tests and urine tests. Your overall health, and the size and location of your stone will be considered. […] Later, your doctor will want to find the cause of the stone. The stone will be analyzed after it comes out of your body, and your doctor will test your blood for calcium, phosphorus and uric acid. The doctor may also ask that you collect your urine for 24 hours to test for calcium and uric acid.

• #36 Nephrolithiasis Workup: Approach Considerations, Urinalysis, Blood Studies

  https://emedicine.medscape.com/article/437096-workup

  Renal ultrasonography by itself is frequently adequate to determine the presence of a renal stone. […] Before the advent of helical CT, IVP, also known as intravenous urography (IVU), was the test of choice in diagnosing ureterolithiasis. […] The main advantage of IVP is the clear outline of the entire urinary system that it provides, making visualization of even mild hydronephrosis relatively easy. […] CT scanning has replaced IVP, the historic criterion standard, for the assessment of urinary tract stone disease, especially for acute renal colic. […] A renal colic study consists of a noncontrast or unenhanced CT scan of the abdomen and pelvis, including very narrow cuts taken through the kidneys and bladder areas, where symptomatic stones are most likely to be encountered. […] In current clinical practice, the renal colic noncontrast CT scan is the standard of care in most EDs when a patient is thought to have renal colic or presents with acute flank pain.

• #37 Kidney stones – Symptoms, causes, types, and treatment | National Kidney Foundation

  https://www.kidney.org/kidney-topics/kidney-stones

  Diagnosis of a kidney stone starts with a medical history, physical examination, and imaging tests. Your doctors will want to know the exact size and shape of the kidney stones. This can be done with a high resolution CT scan from the kidneys down to the bladder or an x-ray called a „KUB x-ray” (kidney-ureter-bladder x-ray) which will show the size of the stone and its position. The KUB x-ray is often obtained by the surgeons to determine if the stone is suitable for shock wave treatment. The KUB test may be used to monitor your stone before and after treatment, but the CT scan is usually preferred for diagnosis. In some people, doctors will also order an intravenous pyelogram or lVP, a special type of X-ray of the urinary system that is taken after injecting a dye. […] Second, your doctors will decide how to treat your stone. The health of your kidneys will be evaluated by blood tests and urine tests. Your overall health, and the size and location of your stone will be considered. […] Later, your doctor will want to find the cause of the stone. The stone will be analyzed after it comes out of your body, and your doctor will test your blood for calcium, phosphorus and uric acid. The doctor may also ask that you collect your urine for 24 hours to test for calcium and uric acid.

• #38 Diagnosing Kidney Stones | NYU Langone Health

  https://nyulangone.org/conditions/kidney-stones/diagnosis

  Your doctor may recommend an ultrasound scan to evaluate your kidneys, bladder, and ureters, which are the tubes that carry urine from the kidneys to the bladder. […] A kidney-ureter-bladder, or KUB, X-ray of the abdomen and pelvis can help doctors to determine whether a kidney stone has grown, passed, or returned. […] Your doctor may use a CT scan to look for stones in the kidneys, ureters, and bladder to determine their size and exact location, and to evaluate the anatomy of your urinary tract. […] MRI scans, in which magnetic waves are used to create computerized two- or three-dimensional images, are not typically used to evaluate kidney stones. However, this procedure, which does not use radiation, can sometimes help to safely diagnose kidney stones in pregnant women.

• #39 Kidney stones – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/kidney-stones/diagnosis-treatment/drc-20355759

  You may be asked to urinate through a strainer to catch any stones that you pass. Then a lab checks the chemical makeup of your kidney stones. Your healthcare professional uses this information to find out what’s causing your kidney stones and to form a plan to prevent more kidney stones. […] If your healthcare professional thinks you might have such a condition, your healthcare professional may recommend genetic testing to find out for sure.

• #40 Kidney Stones: Medical Mangement Guideline – American Urological Association

  https://www.auanet.org/guidelines-and-quality/guidelines/kidney-stones-medical-mangement-guideline

  When a stone is available, clinicians should obtain a stone analysis at least once. (Clinical Principle) […] Clinicians should obtain or review available imaging studies to quantify stone burden. (Clinical Principle) […] Clinicians should perform additional metabolic testing in high-risk or interested first-time stone formers and recurrent stone formers. (Standard; Evidence Strength: Grade B) […] Clinicians should recommend to all stone formers a fluid intake that will achieve a urine volume of at least 2.5 liters daily. (Standard; Evidence Strength: Grade B) […] Clinicians should offer thiazide diuretics to patients with high or relatively high urine calcium and recurrent calcium stones. (Standard; Evidence Strength Grade B) […] Clinicians should offer potassium citrate therapy to patients with recurrent calcium stones and low or relatively low urinary citrate. (Standard; Evidence Strength Grade B)

• #41

  https://www.beaumont.org/treatments/kidney-ureteral-stones-diagnosis

  Your doctor may order a stone analysis if you already know you have kidney or ureteral stones. For this test, you will have to urinate through a device with a strainer that can catch stones so they can be analyzed in a lab. Lab analysis will help your doctor know what type of stones you have so the best treatment can be offered.

• #42 Kidney Stones: Symptoms, Diagnosis & Treatment

  https://www.urgentcare247.com/blog/kidney-stones-symptoms-diagnosis-treatment

  When a patient has their first kidney stone, we encourage them to actually give them a filter to urinate through so that they can capture the kidney stone when they ultimately pass it and it can be sent to the laboratory for analysis to find out if it’s a calcium based or a uric acid based stone, because the treatment and the recommendations for those two different types of kidney stones are very different. […] If you are having difficulty keeping fluids down or the pain persists or is worsening, seek medical attention immediately, so they can assess your hydration status, give you effective pain management, anti nausea and vomiting medications, and also imaging to determine the size of the kidney stone. […] If you got a kidney stone, there’s some pretty distinct features that will point to that diagnosis, the most common symptoms being pain and nausea, and getting medical attention to determine the type of stain that you have treating the symptoms effectively and determining size of the stain to determine an ongoing treatment plan for conservative measures to allow the stand to pass on its own or, if more invasive requirements such as lithotripsy or surgical or cystoscopy are required.

• #43 Kidney stones in adults: Evaluation of the patient with established stone disease – UpToDate

  https://www.uptodate.com/contents/kidney-stones-in-adults-evaluation-of-the-patient-with-established-stone-disease

  Analysis of the stone is an essential part of the evaluation. Patients should be encouraged to retrieve stones they pass spontaneously for analysis, although novel CT imaging techniques may permit noninvasive discrimination among the main subtypes of urinary calculi. […] A complete metabolic evaluation consists of a urinalysis, routine blood chemistries, and at least two 24-hour urine collections for analysis of urine composition. […] Monitoring should be performed initially at one year and, if negative, every two to four years thereafter depending upon the severity of the stone disease and the 24-hour urine values. […] Some patients are found to have an asymptomatic kidney stone or stones by imaging performed for a different indication. Such patients may also benefit from a metabolic evaluation and appropriate medical therapy to prevent growth of any existing stones and to prevent new stone formation.

• #44 Nephrolithiasis Workup: Approach Considerations, Urinalysis, Blood Studies

  https://emedicine.medscape.com/article/437096-workup

  The following are objective indications for a metabolic evaluation with a 24-hour urinalysis: Residual calculi after surgical treatment; Initial presentation with multiple calculi; Initial presentation before age 30 years; Renal failure; Solitary kidney (including renal transplant); Family history of calculi; More than 1 stone in the past year; Bilateral calculi. […] The most common findings on 24-hour urine studies include hypercalciuria, hyperoxaluria, hyperuricosuria, hypocitraturia, and low urinary volume. […] A urine pH greater than 7 suggests presence of urea-splitting organisms, such as Proteus, Pseudomonas, or Klebsiella species, and struvite stones. A urine pH less than 5 suggests uric acid stones. […] Plain abdominal radiography (also referred to as flat plate or KUB radiography) is useful for assessing total stone burden, as well as the size, shape, composition, and location of urinary calculi in some patients.

• #45 Kidney stones in adults: Evaluation of the patient with established stone disease – UpToDate

  https://www.uptodate.com/contents/kidney-stones-in-adults-evaluation-of-the-patient-with-established-stone-disease

  Analysis of the stone is an essential part of the evaluation. Patients should be encouraged to retrieve stones they pass spontaneously for analysis, although novel CT imaging techniques may permit noninvasive discrimination among the main subtypes of urinary calculi. […] A complete metabolic evaluation consists of a urinalysis, routine blood chemistries, and at least two 24-hour urine collections for analysis of urine composition. […] Monitoring should be performed initially at one year and, if negative, every two to four years thereafter depending upon the severity of the stone disease and the 24-hour urine values. […] Some patients are found to have an asymptomatic kidney stone or stones by imaging performed for a different indication. Such patients may also benefit from a metabolic evaluation and appropriate medical therapy to prevent growth of any existing stones and to prevent new stone formation.

• #46 Kidney Stones: Medical Mangement Guideline – American Urological Association

  https://www.auanet.org/guidelines-and-quality/guidelines/kidney-stones-medical-mangement-guideline

  When a stone is available, clinicians should obtain a stone analysis at least once. (Clinical Principle) […] Clinicians should obtain or review available imaging studies to quantify stone burden. (Clinical Principle) […] Clinicians should perform additional metabolic testing in high-risk or interested first-time stone formers and recurrent stone formers. (Standard; Evidence Strength: Grade B) […] Clinicians should recommend to all stone formers a fluid intake that will achieve a urine volume of at least 2.5 liters daily. (Standard; Evidence Strength: Grade B) […] Clinicians should offer thiazide diuretics to patients with high or relatively high urine calcium and recurrent calcium stones. (Standard; Evidence Strength Grade B) […] Clinicians should offer potassium citrate therapy to patients with recurrent calcium stones and low or relatively low urinary citrate. (Standard; Evidence Strength Grade B)

• #47 Nephrolithiasis – Symptoms, Diagnosis and Treatment.

  https://www.erknet.org/guidelines-pathways/metabolic-stone-disorders/nephrolithiasis

  Diagnosis of nephrolithiasis usually involves a combination of medical history, physical examination, and imaging tests, such as X-rays, ultrasound, or CT scans, to visualize the stones and determine their size and location. […] With fever or solitary kidney, and when diagnosis is doubtful, immediate imaging is indicated. Following initial US assessment, non contrast enhanced computed tomography should be used to confirm stone diagnosis in patients with acute flank pain. […] Clinicians should perform additional metabolic testing in high-risk or interested first-time stone formers and recurrent stone formers. […] Metabolic testing should consist of one or two 24-hour urine collections obtained on a random diet and analyzed at minimum for total volume, pH, calcium, oxalate, uric acid, citrate, sodium, potassium and creatinine.

• #48 Nephrolithiasis Workup: Approach Considerations, Urinalysis, Blood Studies

  https://emedicine.medscape.com/article/437096-workup

  The following are objective indications for a metabolic evaluation with a 24-hour urinalysis: Residual calculi after surgical treatment; Initial presentation with multiple calculi; Initial presentation before age 30 years; Renal failure; Solitary kidney (including renal transplant); Family history of calculi; More than 1 stone in the past year; Bilateral calculi. […] The most common findings on 24-hour urine studies include hypercalciuria, hyperoxaluria, hyperuricosuria, hypocitraturia, and low urinary volume. […] A urine pH greater than 7 suggests presence of urea-splitting organisms, such as Proteus, Pseudomonas, or Klebsiella species, and struvite stones. A urine pH less than 5 suggests uric acid stones. […] Plain abdominal radiography (also referred to as flat plate or KUB radiography) is useful for assessing total stone burden, as well as the size, shape, composition, and location of urinary calculi in some patients.

• #49 Nephrolithiasis Differential Diagnoses

  https://emedicine.medscape.com/article/437096-differential

  Moore and colleagues derived and validated an objective clinical prediction rule for uncomplicated ureteral stones that uses five patient factorssex, timing, origin (ie, race), nausea, and erythrocytes (STONE)to create a score between 0 and 13 (the STONE score). Patients with a high STONE score are very likely to have a kidney stone and very unlikely to have an important disorder other than a kidney stone as a cause of their symptoms, and thus may be able to avoid a computed tomography (CT) scan or be evaluated with a reduced-dose scan. […] The diagnosis of stone is often made on the basis of clinical symptoms alone, although confirmatory tests are usually performed. At this point, the goals and opinions of physicians in different specialties diverge. […] A urologist, who must ultimately make the decision about possible surgery, may require additional information. Before such a decision can be made, a urologist must know about the size, orientation, radiolucency, composition, and location of the stone and must know about overall kidney function, the presence of any infection, and other clinical information.

• #50

• #51 Nephrolithiasis Differential Diagnoses

  https://emedicine.medscape.com/article/437096-differential

  Beware of the patient older than 60 years with an apparent first kidney stone. Consider the possibility of symptomatic AAA in the older patient, and rule out this possibility before pursuing the diagnosis of nephrolithiasis. Use bedside ultrasonography if the patients condition is potentially unstable. CT scan is a reasonable alternative in the stable patient. […] Failure to diagnose or delay in diagnosis of symptomatic AAA may lead to medicolegal liability. The pain of a leaking AAA is often misdiagnosed initially as renal colic. […] Failure to diagnose and promptly treat a urinary tract infection (UTI) proximal to a ureteral stone is also a potential source of medicolegal liability. Urgent urologic intervention must be sought in these patients.

• #52 Diagnosis of Kidney Stones in Children – NIDDK

  https://www.niddk.nih.gov/health-information/urologic-diseases/kidney-stones-children/diagnosis

  To diagnose kidney stones health care professionals use a childs […] Health care professionals may use lab or imaging tests to diagnose kidney stones. […] Urine tests can show whether there are high levels of minerals that could form kidney stones. Urine and blood tests can also help determine which type of kidney stone is causing a childs symptoms. […] Imaging tests can help find kidney stones. The tests may also show problems that caused a kidney stone to form, such as a birth defect or blockage in the urinary tract. […] An ultrasound is often the first choice when a child needs an imaging test to find a kidney stone. […] CT scans can show the size and location of a kidney stone, whether the stone is blocking the urinary tract, and conditions that may have caused the kidney stone to form.

• #53 Kidney Stones | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/kidney-stones

  Kidney stones can affect different children in different ways. Young children in particular may have vague symptoms that can make diagnosis challenging. […] The first step in treating your child is forming an accurate and complete diagnosis. Our doctors can tell if your child has a kidney stone by looking at their urinary tract with an ultrasound or a CT scan. Ultrasound is our first diagnostic choice because it doesn’t expose your child to radiation. […] If the ultrasound is inconclusive — or if your child’s doctor has any questions about it — we might do a CT scan. A CT scan can help your child’s doctor locate the exact position and size of the stone for surgical planning. […] During your appointment, you and your child will meet with a pediatric urologist and a pediatric nephrologist for a physical exam and discussion of your child’s health, including a review of current prescribed and over-the-counter medications, and a detailed history of your child’s diet and fluid intake.

• #54 Kidney Stone Disease | MedStar Health

  https://www.medstarhealth.org/services/kidney-stones

  The MedStar Health Comprehensive Kidney Stone program has extensive experience treating the most complicated patients with kidney stones in the Mid-Atlantic region. […] Our highly experienced team of surgeons utilizes the latest technology and techniques to perform state-of-the-art procedures for stone removal, including same-day surgery for the most complex stone cases. […] Identifying your kidney stone type is important to determining the cause of your stone and preventing future stones. […] Our kidney stone experts evaluate your medical history and personal risk factors for stone recurrence, which helps us tailor a plan to prevent future kidney stones. […] We also perform a comprehensive evaluation, which aids in determining the right steps for prevention. […] Your treatment will vary depending on several factors, including: Stone size, Location, Composition, Urinary tract anatomy, Associated symptoms.

• #55 Kidney Stones

  https://dcurology.net/common-problems/kidney-stones.php

  Another very common problem seen in an Urologists office, particularly here in the Mid-Atlantic and Southeastern United States (sometimes referred to as the stone belt) is kidney stones. […] Today stones that do not pass on their own are nearly always treated in a minimally invasive fashion. […] If such an abnormality is suspected, special test will be performed and chronic medication may be prescribed. […] One of the first things an Urologist will want to determine is whether a uric acid stone is suspected or not when a stone is present as this may affect how that stone will be managed. […] Stones are discovered in one of three ways. A patient may undergo a radiologic exam for an unrelated reason when a stone is found incidentally. […] When a stone is uncovered, the most important detail that must be known to advise the patient as to what to do is the size of the stone.

• #56 Kidney Stones

  https://dcurology.net/common-problems/kidney-stones.php

  Most stones are small enough that they do not cause severe pain and pass easily through the ureter. […] Very small stones (1-3mm) will likely pass and do not often require treatment. Small stones can still cause obstruction and damage to the kidney. […] Larger stones (5mm or larger) are less likely to pass. […] Treatment options include: Extra-Corporeal Shock Wave Lithotripsy (ESWL), Ureteroscopy with Laser Lithotripsy, Percutaneous Nephrolithotomy for very large stones.

• #57 EAU Guidelines on Urolithiasis – Uroweb

  https://uroweb.org/guidelines/urolithiasis/chapter/guidelines

  Medical expulsive therapy seems efficacious for treating patients with ureteral stones who are amenable to conservative management. The greatest benefit might be among those with 5 mm (distal) ureteral stones. […] Shock wave lithotripsy is still the first-line treatment for most ureteral stones in children. […] Ureteroscopy has become the treatment of choice for larger distal ureteral stones in children. […] In children, the indications for SWL, URS and PCNL are similar to those in adults.

• #58 Kidney stones – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/kidney-stones/symptoms-causes/syc-20355755

  Make an appointment with your healthcare professional if you have any symptoms that worry you. […] Get a healthcare checkup right away if you have: Pain so bad that you can’t sit still or find a comfortable position. […] Kidney stones often have no definite, single cause. But many factors may raise your risk. […] Knowing the type of kidney stone you have helps your healthcare professional figure out its cause and the right treatment for you. […] The type of medicine that your healthcare professional prescribes depends on the kind of kidney stones you have. […] To help prevent calcium stones from forming, your healthcare professional may prescribe a thiazide diuretic or potassium citrate. […] Your healthcare professional may prescribe allopurinol (Zyloprim, Aloprim, others) to lower uric acid levels in your blood and urine. […] To prevent struvite stones, your healthcare professional may recommend ways to keep your urine free of bacteria that cause infection. […] A diet that’s lower in sodium and protein may help prevent cystine stones.

• #59 EAU Guidelines on Urolithiasis – Uroweb

  https://uroweb.org/guidelines/urolithiasis/chapter/guidelines

  The easiest method for diagnosing stones is by analysis of a passed stone using a validated method. Once the mineral composition is known, a potential metabolic disorder can be identified. […] Stone analysis should be performed on all first-time stone formers. […] The obstructed kidney with all signs of urinary tract infection (UTI) and/or anuria is a urological emergency. Urgent decompression is often necessary to prevent further complications in infected hydronephrosis secondary to stone-induced, unilateral, or bilateral, renal obstruction. […] Non-steroidal anti-inflammatory drugs are very effective in treating renal colic and are superior to opioids. […] For decompression of the renal collecting system, ureteral stents and percutaneous nephrostomy catheters are equally effective.

• #60 Kidney Stones: Diagnosis, Work Up and Management – The ObG Project

  https://www.obgproject.com/2021/05/09/kidney-stones-diagnosis-work-up-and-management/

  CBC […] Creatinine […] The most important key to managing patient with nephrolithiasis is determining whether urgent intervention is needed. […] Repeat imaging after 2 weeks to assess stone position and look for hydronephrosis. […] Referral to urology if no improvement after 2 to 4 weeks. […] Urgent intervention required for the following: […] Obstructed upper urinary tract with infection/sepsis […] Pain refractory to analgesics […] Anuria […] Impending renal deterioration (abnormal creatinine) […] Intractable nausea and vomiting […] Solitary kidney […] Hemodynamic instability […] Patient preference […] false

• #61 Kidney Stones: Diagnosis, Work Up and Management – The ObG Project

  https://www.obgproject.com/2021/05/09/kidney-stones-diagnosis-work-up-and-management/

  CBC […] Creatinine […] The most important key to managing patient with nephrolithiasis is determining whether urgent intervention is needed. […] Repeat imaging after 2 weeks to assess stone position and look for hydronephrosis. […] Referral to urology if no improvement after 2 to 4 weeks. […] Urgent intervention required for the following: […] Obstructed upper urinary tract with infection/sepsis […] Pain refractory to analgesics […] Anuria […] Impending renal deterioration (abnormal creatinine) […] Intractable nausea and vomiting […] Solitary kidney […] Hemodynamic instability […] Patient preference […] false

• #62 Kidney Stone Diagnosis and Treatment – Cincinnati Kidney Docs Blog

  https://www.cincinnatikidneydocs.com/blog/kidney-stone-diagnosis-treatment/

  Imaging tests like abdominal x-rays, ultrasounds, or CT scans may be used to locate a kidney stone and recommend a treatment plan. […] If small kidney stones are detected, you may be asked to pee through a strainer to catch passed stones for analysis. Determining the makeup of the stones can help your nephrologist identify whats causing them and form a prevention plan for you. […] The size and cause of the stone will determine what treatment your nephrologist recommends. […] Small kidney stones dont typically need invasive treatment. You may be instructed to drink enough water (up to 2 or 3 quarts) to produce clear urine. This dilutes your urine and may be enough to pass a small stone. […] Your nephrologist might suggest taking over the counter pain relievers like Advil or Tylenol to relieve discomfort caused by passing the stones. An alpha blocker may also be prescribed to help you pass the kidney stone faster with less discomfort.

• #63 Kidney Stone Diagnosis and Treatment – Cincinnati Kidney Docs Blog

  https://www.cincinnatikidneydocs.com/blog/kidney-stone-diagnosis-treatment/

  Kidney stones that are too big to be passed through the urinary tract will need to be removed with a procedure. […] Shock wave therapy uses sound waves to produce vibrations that break the kidney stone into smaller pieces. The procedure takes about an hour and can be administered under light anesthesia or sedation. […] If ESWL is not successful, your nephrologist may recommend surgically removing the stone. This procedure uses small instruments to extract the kidney stone and is administered under general anesthesia. […] Small to mid-sized kidney stones in your ureter or kidney may be successfully broken up during a scope procedure. A thin tube with a camera on the end, called a ureteroscope, is first passed through the urethra and bladder to locate the stone. Then, your doctor will use tools that can capture the stone or break it into pieces. A stent may be placed in the ureter to help relieve swelling and encourage healing. […] If you think you have a kidney stone, the Nephrology Associates of Greater Cincinnati can help. Our physicians specialize in treating larger kidney stones, complex kidney stone conditions, and stone prevention.

• #64 How to Know If You Have Kidney Stones: Symptoms and Signs

  https://www.webmd.com/kidney-stones/do-i-have-kidney-stones

  Imaging procedures can help spot how many kidney stones you have, their size, and where in your body they are. […] If other people in your family get kidney stones or you first got them as a child or teen, your doctor may suggest a genetic test. This can help ID any conditions that run in your family that may be causing your kidney stones. […] How your kidney stone is treated depends on many factors, including how many you have, their size, where they are, and the amount of pain you’re in. […] If the stone is small and your pain isn’t severe, your doctor may take a wait-and-see approach. […] Stones that are too large to pass or risk causing other health issues can be treated a few different ways, including: […] Once the stone or stone fragments are out of your body, your doctor may want to send them to a lab. […] Kidney stones aren’t life-threatening, but they can be intensely painful and lead to other health issues. See a doctor right away if you think you have one. Your doctor can do tests to figure out the next best steps to take and help you prevent new stones from forming.

• #65 Kidney Stone Diagnosis and Treatment – Cincinnati Kidney Docs Blog

  https://www.cincinnatikidneydocs.com/blog/kidney-stone-diagnosis-treatment/

  Kidney stones that are too big to be passed through the urinary tract will need to be removed with a procedure. […] Shock wave therapy uses sound waves to produce vibrations that break the kidney stone into smaller pieces. The procedure takes about an hour and can be administered under light anesthesia or sedation. […] If ESWL is not successful, your nephrologist may recommend surgically removing the stone. This procedure uses small instruments to extract the kidney stone and is administered under general anesthesia. […] Small to mid-sized kidney stones in your ureter or kidney may be successfully broken up during a scope procedure. A thin tube with a camera on the end, called a ureteroscope, is first passed through the urethra and bladder to locate the stone. Then, your doctor will use tools that can capture the stone or break it into pieces. A stent may be placed in the ureter to help relieve swelling and encourage healing. […] If you think you have a kidney stone, the Nephrology Associates of Greater Cincinnati can help. Our physicians specialize in treating larger kidney stones, complex kidney stone conditions, and stone prevention.

• #66 Kidney Stones Symptoms, Risk Factors, and Diagnosis | Saint John’s Cancer Institute – Santa Monica, CA

  https://www.saintjohnscancer.org/urology/conditions/kidney-stones/

  Ureteroscopy (URS) is an outpatient procedure most commonly performed to treat stones in the ureters (narrow tubes that connect the kidneys to the bladder). URS can also be used to treat stones in the kidney. The device consists of a thin, fiber optic camera which helps the urologist guide the flexible instrument, traversing into the bladder, up the ureter, and into the kidney. The URS device also has a built-in laser, which is used to bombard the stone into smaller pieces. The smaller pieces of the stone can then be collected and removed by the urologist.

• #67 Medical Codes to Report Kidney Stones

  https://www.outsourcestrategies.com/resources/use-correct-medical-codes-to-report-kidney-stones/

  Kidney stones are the calcifications (body’s excess minerals and salts) that can form inside your kidneys. […] Diagnosis of kidney stones involves a detailed health assessment and physical examination. Initial procedure involves blood and urine testing to identify the exact causes of stones. […] As part of the diagnosis, urologists or other physicians may request diagnostic imaging tests such as abdominal X-rays, Intravenous pyelogram (IVP), retrograde pyelogram, Ultrasound of the kidney, MRI scan of the abdomen and kidneys and abdominal CT scan as these identify kidney stones in your urinary tract. […] Treatment for kidney stones varies, depending on the type of stone and the cause. Generally, small kidney stones will not require any invasive form of treatment. […] Kidney stones that are too large to pass on their own because they cause bleeding, kidney damage or ongoing urinary tract infections may require more-extensive treatment which include – extracorporeal shock wave lithotripsy (ESWL), Tunnel surgery (percutaneous nephrolithotomy) and Ureteroscopy.

• #68 Kidney Stones: Medical Mangement Guideline – American Urological Association

  https://www.auanet.org/guidelines-and-quality/guidelines/kidney-stones-medical-mangement-guideline

  Clinicians should obtain a single 24-hour urine specimen for stone risk factors within six months of the initiation of treatment to assess response to dietary and/or medical therapy. (Expert Opinion) […] Clinicians should obtain periodic blood testing to assess for adverse effects in patients on pharmacological therapy. (Standard; Evidence Strength Grade: A) […] Clinicians should monitor patients with struvite stones for reinfection with urease-producing organisms and utilize strategies to prevent such occurrences. (Expert Opinion) […] Clinicians should periodically obtain follow-up imaging studies to assess for stone growth or new stone formation based on stone activity (plain abdominal imaging, renal ultrasonography or low dose computed tomography [CT]). (Expert Opinion)

• #69 Kidney stones in adults: Evaluation of the patient with established stone disease – UpToDate

  https://www.uptodate.com/contents/kidney-stones-in-adults-evaluation-of-the-patient-with-established-stone-disease

  Analysis of the stone is an essential part of the evaluation. Patients should be encouraged to retrieve stones they pass spontaneously for analysis, although novel CT imaging techniques may permit noninvasive discrimination among the main subtypes of urinary calculi. […] A complete metabolic evaluation consists of a urinalysis, routine blood chemistries, and at least two 24-hour urine collections for analysis of urine composition. […] Monitoring should be performed initially at one year and, if negative, every two to four years thereafter depending upon the severity of the stone disease and the 24-hour urine values. […] Some patients are found to have an asymptomatic kidney stone or stones by imaging performed for a different indication. Such patients may also benefit from a metabolic evaluation and appropriate medical therapy to prevent growth of any existing stones and to prevent new stone formation.

• #70 Kidney Stones: Medical Mangement Guideline – American Urological Association

  https://www.auanet.org/guidelines-and-quality/guidelines/kidney-stones-medical-mangement-guideline

  Clinicians should obtain a single 24-hour urine specimen for stone risk factors within six months of the initiation of treatment to assess response to dietary and/or medical therapy. (Expert Opinion) […] Clinicians should obtain periodic blood testing to assess for adverse effects in patients on pharmacological therapy. (Standard; Evidence Strength Grade: A) […] Clinicians should monitor patients with struvite stones for reinfection with urease-producing organisms and utilize strategies to prevent such occurrences. (Expert Opinion) […] Clinicians should periodically obtain follow-up imaging studies to assess for stone growth or new stone formation based on stone activity (plain abdominal imaging, renal ultrasonography or low dose computed tomography [CT]). (Expert Opinion)

• #71 Kidney Stones: Medical Mangement Guideline – American Urological Association

  https://www.auanet.org/guidelines-and-quality/guidelines/kidney-stones-medical-mangement-guideline

  Clinicians should obtain a single 24-hour urine specimen for stone risk factors within six months of the initiation of treatment to assess response to dietary and/or medical therapy. (Expert Opinion) […] Clinicians should obtain periodic blood testing to assess for adverse effects in patients on pharmacological therapy. (Standard; Evidence Strength Grade: A) […] Clinicians should monitor patients with struvite stones for reinfection with urease-producing organisms and utilize strategies to prevent such occurrences. (Expert Opinion) […] Clinicians should periodically obtain follow-up imaging studies to assess for stone growth or new stone formation based on stone activity (plain abdominal imaging, renal ultrasonography or low dose computed tomography [CT]). (Expert Opinion)

• #72 Kidney Stones: Medical Mangement Guideline – American Urological Association

  https://www.auanet.org/guidelines-and-quality/guidelines/kidney-stones-medical-mangement-guideline

  When a stone is available, clinicians should obtain a stone analysis at least once. (Clinical Principle) […] Clinicians should obtain or review available imaging studies to quantify stone burden. (Clinical Principle) […] Clinicians should perform additional metabolic testing in high-risk or interested first-time stone formers and recurrent stone formers. (Standard; Evidence Strength: Grade B) […] Clinicians should recommend to all stone formers a fluid intake that will achieve a urine volume of at least 2.5 liters daily. (Standard; Evidence Strength: Grade B) […] Clinicians should offer thiazide diuretics to patients with high or relatively high urine calcium and recurrent calcium stones. (Standard; Evidence Strength Grade B) […] Clinicians should offer potassium citrate therapy to patients with recurrent calcium stones and low or relatively low urinary citrate. (Standard; Evidence Strength Grade B)

• #73 Kidney stones – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/kidney-stones/symptoms-causes/syc-20355755

  Make an appointment with your healthcare professional if you have any symptoms that worry you. […] Get a healthcare checkup right away if you have: Pain so bad that you can’t sit still or find a comfortable position. […] Kidney stones often have no definite, single cause. But many factors may raise your risk. […] Knowing the type of kidney stone you have helps your healthcare professional figure out its cause and the right treatment for you. […] The type of medicine that your healthcare professional prescribes depends on the kind of kidney stones you have. […] To help prevent calcium stones from forming, your healthcare professional may prescribe a thiazide diuretic or potassium citrate. […] Your healthcare professional may prescribe allopurinol (Zyloprim, Aloprim, others) to lower uric acid levels in your blood and urine. […] To prevent struvite stones, your healthcare professional may recommend ways to keep your urine free of bacteria that cause infection. […] A diet that’s lower in sodium and protein may help prevent cystine stones.

• #74 Kidney Stones: Medical Mangement Guideline – American Urological Association

  https://www.auanet.org/guidelines-and-quality/guidelines/kidney-stones-medical-mangement-guideline

  When a stone is available, clinicians should obtain a stone analysis at least once. (Clinical Principle) […] Clinicians should obtain or review available imaging studies to quantify stone burden. (Clinical Principle) […] Clinicians should perform additional metabolic testing in high-risk or interested first-time stone formers and recurrent stone formers. (Standard; Evidence Strength: Grade B) […] Clinicians should recommend to all stone formers a fluid intake that will achieve a urine volume of at least 2.5 liters daily. (Standard; Evidence Strength: Grade B) […] Clinicians should offer thiazide diuretics to patients with high or relatively high urine calcium and recurrent calcium stones. (Standard; Evidence Strength Grade B) […] Clinicians should offer potassium citrate therapy to patients with recurrent calcium stones and low or relatively low urinary citrate. (Standard; Evidence Strength Grade B)

• #75 Diagnosing Kidney Stones | NYU Langone Health

  https://nyulangone.org/conditions/kidney-stones/diagnosis

  Kidney stones are common: Nearly one in 10 Americans is diagnosed with one at some point. Without treatment and preventive efforts, half of all people who have been treated for one or more kidney stones develop another within five to 10 years. […] Your doctor conducts an initial physical exam and may order several tests, including blood and urine tests and imaging exams, to determine whether you have kidney stones and to diagnose the particular type and location. […] During your initial exam, your doctor may collect a small amount of blood in order to assess your kidney function, look for signs of infection, and test for factors that can contribute to the formation of kidney stones, such as high calcium levels, parathyroid hormone, and uric acid. […] Your doctor may analyze a sample of your urine in order to check for crystals, which can lead to the formation of kidney stones, and order a urine culture to determine if you have a urinary tract infection.

• #76

  https://www.nhs.uk/conditions/kidney-stones/

  Kidney stones can develop in 1 or both kidneys and most often affect people aged 30 to 60. […] Kidney stones are usually found in the kidneys or in the ureter, the tube that connects the kidneys to your bladder. […] After a kidney stone has formed, your body will try to pass it out when you pee. […] Most kidney stones are small enough to be passed in your pee, and it may be possible to treat the symptoms at home with medication. […] Larger stones may need to be broken up or removed with surgery. […] It’s estimated up to half of all people who have had kidney stones will experience them again within the following 5 years. […] To avoid getting kidney stones, make sure you drink plenty of water every day so you do not become dehydrated. […] It’s very important to keep your urine pale in colour to prevent waste products forming into kidney stones.

• #77 Kidney Stone Testing – Testing.com

  https://www.testing.com/kidney-stone-testing/

  The results of kidney stone testing will normally be provided by your doctor. In some cases, a doctor who specializes in conditions of the urinary tract, called a urologist, may be involved in your care and deliver test results. […] Frequently, the diagnosis and management of kidney stones requires more than one test. As a result, the doctor may need to receive all of the test results before being able to explain their overall significance in your situation. […] If a kidney stone is diagnosed, your doctor will discuss whether any treatment is necessary so that the stone can pass without causing a blockage in your urinary tract. They may also review options for reducing your symptoms or preventing complications. If no kidney stone is found, other tests may be needed to determine the cause of your symptoms.

• #78 Kidney Stones: Current Diagnosis and Management | MDedge

  https://community.the-hospitalist.org/content/kidney-stones-current-diagnosis-and-management-0

  The ever-increasing significance of nephrolithiasis has mandated an organized and systematic management approach. Indeed, the diagnosis and initial therapy for kidney stones have undergone considerable evolution in recent years. The basic tenets of nephrolithiasis management include early diagnosis and pertinent treatment as well as adequate prophylaxis to prevent subsequent stone recurrence.

• #79 Kidney stones in adults: Evaluation of the patient with established stone disease – UpToDate

  https://www.uptodate.com/contents/kidney-stones-in-adults-evaluation-of-the-patient-with-established-stone-disease

  Kidney stone disease (nephrolithiasis) is a common problem in primary care practice. Patients may present with the classic symptoms of renal colic and hematuria. Some patients may be asymptomatic or have atypical symptoms such as vague abdominal pain, while others will have more typical symptoms, such as acute abdominal or flank pain, nausea, urinary urgency or frequency, difficulty urinating, penile pain, or testicular pain. […] In patients with established kidney stone disease, the goal of a diagnostic evaluation is to identify, as efficiently and economically as possible, the particular behavioral and physiologic differences present in a given patient so that effective therapy to prevent recurrent stones can be established and the prognosis can be better defined. […] All patients presenting with established kidney stone disease (either newly diagnosed or recurrent stones) should undergo a focused history, radiologic imaging, stone analysis (if available), and at least a limited laboratory evaluation.

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