Description

Lack of water in the body is one of the main causes of kidney stones. When urine is concentrated, it becomes acidic and contains higher amounts of minerals (such as calcium, oxalate, and uric acid) that can crystalize, stick together and form kidney stones. Some risk factors are males, 30-50 years of age, obesity, intestinal surgery, family history, conditions which increase minerals in the body and previous kidney stones.

In the case of Mr. Burner, he is very at risk for developing kidney stones, being an overweight male, 47 years of age, suffering from hyperparathyroidism and having experienced this previously. His symptoms are very similar as well. With his hyperparathyroidism he is at risk of suffering from hypercalcemia as well. When a kidney stone forms in the kidney, it has to pass through the ureter, bladder and urethra. When it is being forced through these narrow pathways, it causes some of the most intense feelings of pain, may cause bleeding into the urine, Uterine Tract Infections (UTIs) and blockages. The GI tract and kidneys share some nerve endings and so the irritation of the kidneys can be experienced as nausea.

If Mr. Burner’s fully blocks the flow of urine, his situation is emergent and the stone needs to be broken down and passed immediately.

To diagnose that his condition is kidney stones, imaging is required. A CT scan (with or without contrast), ultrasound or an Abdominal x-ray. By running these tests, they can also locate the kidney stone in the urinary tract, determine the size, and determine if a blockage is present.

Since this is suspected to be a reoccurring problem for Mr. Burner, additional testing will be ordered. A blood test and a urine test will be ordered to determine which type of kidney stone he has and how to prevent it from reoccurring. For the blood test, a Lithium Heparin, green top tube will be collected. Blood testing will be done to determine levels of calcium, phosphorus, electrolytes, and uric acid. They will run tests on A 24h urine collection to determine if there is an abnormal amount of crystal forming minerals in the urine. A microscopic analysis can also help to determine if there are crystals, how many crystals and the type of crystal. [i]

References

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4525130/

https://www.healthline.com/health/symptoms-of-kidney-stones

https://www.mayoclinic.org/diseases-conditions/kidney-stones/symptoms-causes/syc-20355755

https://www.mayoclinic.org/diseases-conditions/kidney-stones/diagnosis-treatment/drc-20355759

https://www.everydayhealth.com/kidney-stones/how-doctors-diagnose-kidney-stones-what-know-before-your-appointment/#bloodtests

http://ltd.aruplab.com/Tests/Pub/0020843

https://www.niddk.nih.gov/health-information/urologic-diseases/kidney-stones/diagnosis

https://fac.ksu.edu.sa/sites/default/files/7_qualitative_analysis_of_renal_calculi_.pdf