Fast Five Quiz: Kidney Stones (Renal Calculi)

Vecihi Batuman, MD


May 12, 2021

Urinalysis is a critical part of the evaluation of patients with suspected renal calculi. Gross or microscopic hematuria is present in approximately 85% of patients. The degree of hematuria is not predictive of stone size or likelihood of passage. No literature supports the theory that ureterolithiasis without hematuria is indicative of complete ureteral obstruction. The American Urological Association (AUA) recommends against performing fast and calcium load testing to distinguish among types of hypercalciuria.

Noncontrast abdominopelvic CT is the most sensitive and reliable test in the assessment of patients with renal calculi; however, in some situations, renal ultrasonography or a contrast study, such as intravenous pyelography, may be preferred. Kidney-ureter-bladder radiography, in addition to a CT scan to assess for renal colic, facilitates the review and follow-up of patients with stones. For some stones, ultrasonography works quite well; however, it has been found to be less accurate than intravenous pyelography or CT in the diagnosis of ureteral stones, especially those in the distal ureter.

Read more about the workup of renal calculi.


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