NEPHROLITHIASIS : PATHOPHYSIOLOGY

Modifiable factors:

-Diet (unusually high in soy & fish

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

Uric acid ), ammonia phosphate , and calcium

oxalate stone material deposition on proximal
renal tubule

Super saturation of urine Nephrocalcinosis on proximal

by stone forming tubule
constituents (↓OFI)

Episodes of
Randall’s plaque pain in side
radiating in
the back

Hyperkalemia
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

Renal colic radiating Stones formation <5mm in kidneys Proteinuria

to the back & leg (+1)

Stones obstructing the kidneys

Bilateral swelling of
the knees and Staghorn
adjacent parts calculus
(Edema) Stone matrix & progression

MULTIPLE URINARY CALCULUS