Urolithiasis/nephrolithiasis: what's it all about?

Urolithiasis (urinary tract calculi or stones) and nephrolithiasis (kidney calculi or stones) are well-documented common occurrences in the general population of the United States. The etiology of this disorder is multifactorial and is strongly related to dietary lifestyle habits or practices. Proper management of calculi that occur along the urinary tract includes investigation into causative factors in an effort to prevent recurrences. Urinary calculi or stones are the most common cause of acute ureteral obstruction. Approximately 1 in 1,000 adults in the United States are hospitalized annually for treatment of urinary tract stones, resulting in medical costs of approximately dollar 2 billion per year (Ramello, Vitale, & Marangella, 2000; Tanagho & McAninch, 2004).

The role of diet in the prevention of common kidney stones.

Current dietary recommendations for patients who form kidney stones are discussed. Focusing on the most common kidney stone types, calcium oxalate and uric acid, the rationale for dietary changes are described based on the renal and urine physiology.

Management of calcium oxalate stones.

This article discusses the incidence and prevalence of calcium oxalate renal stones. Etiology and risk factors for all renal stone formation are reviewed. The evaluation, diagnostic procedures, and management for new and recurrent stone formation are detailed. Management includes long-term pharmacologic and nonpharmacologic measures for successful prevention or reduction in the frequency of recurrent stones. Specific patient education factors, patient and family psychological aspects, and referral resources are discussed.

Management of the extracorporeal shock wave lithotripsy patient.

Over 2 million Americans experience kidney and urinary stone disease each year. Early treatments resulted in high mortality and morbidity rates. With the advent of extracorporeal shock wave lithotripsy less than 20 years ago, treatment for this disease has become far safer with more rapid recovery and fewer complications. The selection of patients eligible for extracorporeal shock wave lithotripsy is dependent on the location and size of the stones and the overall health of the patient. This article discusses the different treatment modalities used for stone disease and the different methods currently available for extracorporeal shock wave lithotripsy. Preprocedure preparation of the patient and postoperative care for this population is reviewed in detail.

Extracorporeal shock-wave lithotripsy treatment for kidney stones.

Renal lithiasis, a common malady from which many individuals suffer, can result in significant morbidity and mortality. Few therapeutic options have been available until recently. Extracorporeal shock-wave lithotripsy (ESWL) is a new non-invasive modality for destruction of kidney stones. Shorter hospital stay, radically reduced recovery period and lack of harmful sequelae have rapidly elevated ESWL to the procedure of choice for most renal calculi. Description of ESWL development, the actual procedure and the role of the nurse practitioner are discussed.