Renal Stone on USS/X-Ray

Abstract

The lifetime prevalence of kidney stones in the UK is thought to be approximately 5–12 %. Men are affected two to three times more commonly than women. Peak incidence occurs in the mid-20s and in the fourth to sixth decades. Following a stone episode, 50 % of patients will form another stone within 10 years. Stone formation depends on a number of extrinsic factors such as geography, climate, season, water intake, diet, and occupation. Treatment will depend on symptoms, size, anatomy, infection, and etiology. Not every renal stone, particularly those that are small and asymptomatic, necessarily needs a urological referral. Rather, patients can be effectively managed and followed up by the GP. Some renal stones will need emergency admission if, for example, there is sepsis associated with the stone or if there is pain. We propose a simple algorithm to help facilitate the decision-making process for community practitioners in managing renal stones. Symptomatic patients, patients with stones size >5 mm, or those with certain risk factors will need referral to the local urologist. We feel asymptomatic patients with a solitary nonobstructing renal stone <5 mm could be managed in the community and be monitored with an easy route into secondary care if necessary.