Ambulatory Series: Nephrolithiasis

Host/Editor: Dr. Alla Turshudzhyan, Chief Medical Resident at UCONN. Kidney stones are common and majority of the stones are made up of calcium oxalate, followed by calcium phosphate, uric acid, cystine, and struvite stones. The recurrence rate of kidney stones is quite high, but there are a lot of modifiable risk factors that are crucial we educate our patients about. Some of the modifiable risk factors include decreased fluid intake, low calcium diets, increased oxalate and Vitamin C ingestion, diets low in potassium, high dietary sodium, high dietary non-diary animal protein. When managing a case of kidney stones, it is important to assess patient's discomfort level and escalate pain management as needed starting with NSAIDs. Indications for inpatient admission are poor pain control, inability to tolerate PO, or fever. Stones that are 5-10mm may need an alpha blocker, CCB, or a PDE5 inhibitor to facilitate passage. If stone does not pass after 4 weeks or if stone is more than 10mm, urology consult is indicated. CT abdomen remains the modality of choice for initial image, unless your patient is pregnant. Follow up imaging to confirm stone passage can be done with digital tomosynthesis coupled with an US. We hope you enjoy this episode! Thank you for listening.  

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