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{{Kidney stone}}
{{Kidney stone}}


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==Overview==
Nephrolithiasis may be classified according to American Society of Nephrology based on stone composition into 4 subtypes/groups as calcium stones, [[struvite]] stones[[Uric acid nephrolithiasis|, uric acid stones]] and [[cystine]] stones.


==Classification==
==Classification==
85% of renal stones are made of calcium oxalate.
*Nephrolithiasis may be classified according to American Society of Nephrology based on stone composition into 2 subtypes/groups:<ref name="pmid15191979">{{cite journal |vauthors=Parmar MS |title=Kidney stones |journal=BMJ |volume=328 |issue=7453 |pages=1420–4 |date=June 2004 |pmid=15191979 |pmc=421787 |doi=10.1136/bmj.328.7453.1420 |url=}}</ref><ref name="PfauKnauf2016">{{cite journal|last1=Pfau|first1=Anja|last2=Knauf|first2=Felix|title=Update on Nephrolithiasis: Core Curriculum 2016|journal=American Journal of Kidney Diseases|volume=68|issue=6|year=2016|pages=973–985|issn=02726386|doi=10.1053/j.ajkd.2016.05.016}}</ref>
===Calcium Oxalate Stones===
*Calcium stones
The most common type of kidney stone is composed of [[calcium oxalate]] crystals, and factors that promote the precipitation of crystals in the urine are associated with the development of these stones.
**[[Calcium oxalate]] stones
 
**[[Calcium phosphate|Calcium phosphate stones]]
Conventional wisdom and common sense have long held that consumption of too much [[calcium]] could promote the development of calcium kidney stones. However, current evidence suggests that the consumption of low-calcium diets is actually associated with a higher overall risk for the development of kidney stones. This is perhaps related to the role of calcium in binding ingested oxalate in the gastrointestinal tract. As the amount of calcium intake decreases, the amount of oxalate available for absorption into the bloodstream increases; this oxalate is then excreted in greater amounts into the urine by the kidneys.  In the urine, oxalate is a very strong promoter of calcium oxalate precipitation, about 15 times stronger than calcium.
*[[Struvite]] stones
 
*[[Uric acid nephrolithiasis|Uric acid stones]]
===Other Types===
*[[Cystine]] stones
Other types of kidney stones are composed of [[struvite]] ([[magnesium]], [[ammonium]] and [[phosphate]]); [[uric acid]]; [[calcium phosphate]]; and [[cystine]]. 
 
*The formation of struvite stones is associated with the presence of [[urea]]-splitting bacteria, most commonly ''[[Proteus mirabilis]]'' (but also ''Klebsiella'', ''Serratia'', ''Providencia'' species).  These organisms are capable of splitting urea into [[ammonia]], decreasing the acidity of the urine and resulting in favorable conditions for the formation of struvite stones.  Stuvite stones are always associated with urinary tract infections.
 
*The formation of uric acid stones is associated with conditions that cause high blood uric acid levels, such as [[gout]], leukemias/lymphomas treated by chemotherapy (secondary gout from the death of leukemic cells), and acid/base metabolism disorders where the urine is excessively acid resulting in uric acid precipitation.
 
*The formation of calcium phosphate stones is associated with conditions such as [[hyperparathyroidism]] and renal tubular acidosis. 
 
*The formation of cystine stones is uniquely associated with people suffering from [[cystinuria]], who accumulate cystine in their urine.
 
<div align="left">
<gallery heights="175" widths="175">
Image:Bladder Stone 08783.jpg|Star shaped bladder urolith
Image:Staghorn Kidney Stone 08779.jpg|Staghorn calculus (struvite stone)
</gallery>
</div>


==References==
==References==
{{reflist|2}}
{{Reflist|2}}
 
[[Category:Needs overview]]
[[Category:Disease]]
[[Category:Kidney diseases]]
[[Category:Urology]]
[[Category:Emergency medicine]]
[[Category:Intensive care medicine]]
[[Category:Primary care]]
 
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{{WS}}
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[[Category: (name of the system)]]

Latest revision as of 19:51, 12 August 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Amandeep Singh M.D.[2]

Overview

Nephrolithiasis may be classified according to American Society of Nephrology based on stone composition into 4 subtypes/groups as calcium stones, struvite stones, uric acid stones and cystine stones.

Classification

References

  1. ↑ Parmar MS (June 2004). "Kidney stones". BMJ. 328 (7453): 1420–4. doi:10.1136/bmj.328.7453.1420. PMC 421787. PMID 15191979.
  2. ↑ Pfau, Anja; Knauf, Felix (2016). "Update on Nephrolithiasis: Core Curriculum 2016". American Journal of Kidney Diseases. 68 (6): 973–985. doi:10.1053/j.ajkd.2016.05.016. ISSN 0272-6386.

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