Chapter 148: Nephrolithiasis

Renal calculi are common, affecting ∼1% of the population, and recurrent in more than half of pts. Stone formation begins when urine becomes supersaturated with insoluble components due to (1) low urinary volume, (2) excessive or insufficient excretion of selected compounds, or (3) other factors (e.g., urinary pH) that diminish solubility. Approximately 75% of stones are Ca-based (the majority Ca oxalate; also Ca phosphate and other mixed stones), 15% struvite (magnesium-ammonium-phosphate), 5% uric acid, and 1% cystine, reflecting the metabolic disturbance(s) from which they arise.

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