Eighty percent of patients with kidney stone disease (nephrolithiasis) form calcium stones. The other main types include uric acid, struvite and cystine stones. Individual stones may contain more than one type.
●Clinical manifestations
Although stones may pass asymptomatically, symptoms may occur when stones pass. The most common symptoms and signs are pain (renal colic or flank pain) and gross or microscopic hematuria. Other symptoms include nausea, vomiting, dysuria, and urinary urgency. Nephrolithiasis may lead to persistent kidney obstruction, which could cause permanent kidney damage if left untreated.
●Diagnosis
Nephrolithiasis should be suspected in patients presenting with renal colic or flank pain, with or without hematuria, particularly if the patient has a history of stone disease. Patients should undergo basic laboratory testing and imaging of the kidneys, ureters, and bladder to confirm the presence of a stone and assess for signs of urinary obstruction (eg, hydronephrosis).
•Low-radiation-dose computed tomography (CT) of the abdomen and pelvis without contrast is the preferred examination for most adults as it reliably detects hydronephrosis and demonstrates the highest diagnostic accuracy for nephrolithiasis. CT also accurately describes stone size and location for treatment planning.
•If low-radiation-dose CT is not available, ultrasound of the kidneys and bladder, sometimes in combination with abdominopelvic radiography, is the second-line alternative.
Differential diagnosis
Several conditions may mimic renal colic with or without hematuria
