NEPHROLITHIASIS : PATHOPHYSIOLOGY

Modifiable factors:

-Diet (unusually high in soy & fish

Non modifiable factors: sauce, bagoong, softdrinks, legumes,
protein & salt)
-Age (64 years old) -Certain meds (Analgesics)
-Sex (male) -Low fluid intake
-Urinary stasis
-Smoking & alcoholic drinking
-Gouty arthritis

Uric acid (523.83mmoL/L), ammonia

phosphate (BUN=16.50mmoL/L), and calcium
oxalate stone material deposition on proximal
renal tubule

Super saturation of urine Nephrocalcinosis on proximal

by stone forming tubule
constituents (↓OFI,
pH(5)
Episodes of
Randall’s plaque pain in side
radiating in
the back

Hyperkalemia
(5.62 mmoL/L) Urinary Tract Infection caused by urea
splitting organism

Nidation of crystals or foreign Increase production of Pyuria

bodies from the WBC
supersaturated urine
Nidation of crystals or foreign Increase production of Pyuria
bodies from the WBC
supersaturated urine

Progression of stones in
Loop of Henle
Dysuria

Accumulation of stones & increasing in size

Blood vessels wall surface

attraction and erosion Hematuria

Stones formation <5mm in kidneys Proteinuria

Renal colic radiating (+1)
to the back & leg

Stones >5mm to 10mm obstructing

the kidneys
(15.5mm on left kidney)
(12.2mm on right kidney)

Bilateral swelling of Staghorn

the knees and calculus
adjacent parts Stone matrix & progression
(Edema)

MULTIPLE URINARY CALCULUS