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Disorders of renal calcium handling, urinary stones, and nephrocalcinosis 

Disorders of renal calcium handling, urinary stones, and nephrocalcinosis
Disorders of renal calcium handling, urinary stones, and nephrocalcinosis

Elaine M. Worcester

, Andrew P. Evan

, and Fredric L. Coe


May 30, 2013: This chapter has been re-evaluated and remains up-to-date. No changes have been necessary.


Pathology and pathogenesis—enhanced discussion of mechanisms of formation of apatite plugs that form the nidus for many stones.

Primary hyperoxaluria Type III—brief details of this newly described condition.

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date: 19 September 2021

Renal stones are common, with a prevalence of about 5% in the United States of America. Acute stone passage almost always produces the severe pain of renal colic, but stones are often asymptomatic and discovered incidentally on imaging.

The initial evaluation of patients with renal colic optimally includes noncontrast CT, which can accurately visualize the size and location of stones in the urinary tract. Initial management of stones less than 5 mm in diameter in patients without anatomical abnormalities of the urinary tract is to provide adequate analgesia, followed by watchful waiting to allow time for stone passage. The presence of urinary tract infection, inability to take oral fluids, or obstruction of a single functioning kidney requires hospitalization and active management. Once the acute episode of stone passage or removal is over, thought should be given to diagnosis of the underlying causes of stones, and steps taken towards prevention. Stone analysis is the cornerstone of diagnosis....

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