BATU SALURAN KEMIH

Pembentukan batu di traktus urinarius

1. ETIOLOGI

Non-infection stones

Calcium oxalate

Calcium phosphate,

Uric acid

Infection stones

Magnesium ammonium phosphate

Carbonate apatite

Ammonium urate

Genetic causes

Cystine

Xanthine

2,8-dihydroxyadenine
Drug stones

2. Faktor Resiko

Dehidrasi

Lanang

ISK berulang

Kidney stones may occurs through hereditary

Eating a diet having rich in protein, sodium and sugar may increase your risk of some types
of kidney stones

Cystinuria a genetic disorder which promotes cystine stones

Metabolic disorders may promotes stones

Being obese may increase risk of kidney stones.

Diet tinggi purin

Hyperparatiroid

3. Gejala Klinis
Nausea
Hematuria
Flank Pain
Demam
Ini tergantung lokasinya
4. Diagnosis
Blood test: Blood test reveals the calcium or uric acid level in the blood. Health of the
kidneys also monitored by this test
Urine tests: This test gives the information about any urine infections or urine
contains any substances that form stones
Imaging tests: These tests show the location of kidney stones in the urinary tract.
Some of the tests include Abdominal X-rays, computerized tomography (CT),
ultrasound, and intravenous urography, retrograde pyelogram, abdomen and kidneys
MRI. CT is one of the advanced tests which even reveal tiny stones in the UT.

5. Patomekanisme
Jadi terjadi batu apa ga itu tergantung 2 hal, SOLVENT/pelarut sama terlarutnya aduh
lali inggrise opo. Kids jaman now suka memadukan bahasa indo dan bahasa inggris
Makanya ada to faktor resiko dehidrasi, karena itu salah satu faktornya yaitu
solventnya kurang, jadi terjadi SUPERSATURASI dari elektrolit di sistem urinarius
kita. Sama kayak misal pada kasus hiperparatiroidisme, kalsium didarah banyak,
terjadi peningkatan zat TERLARUT jadinya ujungnya supersaturasi juga. Di sumber
yg ak baca itu nyerinya katanya kolik itu berlangsung terus menerus, tp ada yg bilang
intermitten juga, pokoke nyerinya karena itu kan batunya jalan terutama di 3 tempat
penyempitan traktus urinarius, pelvicuretric junction,pelviclarim,vesicouretra
junction. Terjadi hiperperistaltik jg di ureter
6. Komplikasi
Complications of Urolithiasis
Renal failure
Ureteral stricture
Infection, sepsis
Urine extravasation
 Perinephric abscess

Xanthogranulomatous pyelonephritis
7. Tatalaksana

TREATMENT
Depending on the type and size of kidney stone, treatment may vary.
Small Stones
a. Small stones usually get off from the body without much treatment [46-55].
b. Drinking plenty of water (04-05lts) a day may help flush out the stone through
urine.
c. Pain relievers are used to relieve the pain at the time of stone moving.
d. Medical therapy: Usually doctors suggest an alpha blocker, which relaxes the
muscles in the ureter, helps to pass the kidney stone more quickly and with less pain.
e. Diuretics which increase the urine flow may also chance to pull out the stone.
Large stones
Large stones cannot pass out from the body by their own because of too large. They
also cause bleeding, damage in kidneys (loss of nephrons) or ongoing urinary tract
infections.
Extracorporeal shock wave lithotripsy: In this kidney stones are broken into small
pieces by using sound waves or shock waves to create strong vibrations. The tiny
pieces can be flushed out of the body through urine.
Nephrolithotomy: The doctors generally go for Nephrolithotomy if they find large
stones in or near the kidneys. During surgery the patient receives general anesthesia,
removes the kidney stones by using the thin telescopic instrument.
Ureteroscopy: Ureteroscopy is suggested when a stone gets stuck in the ureter or
bladder. Ureteroscopy is a small wire having a camera at the end is inserted into the
urethra and passed into the bladder. A small cage is used to snag the stone and remove
from the body.
PREVENTION
a. Drinking plenty of water is one of the best ways of preventing kidney stones.
Formation of cleared urine is a sign of getting enough fluids to the body.
b. Proper life style and medication may prevent the reformation of kidney stones
c. Restrict the oxalate-rich foods like spinach, rhubarb, okra, sweet potatoes, tea and
soy products.
d. Reduce the salt intake in diet [61-70].
e. Keep on eating calcium-rich nourishments. Abstains from diet low in calcium can
build kidney stone development in a few people
f. Follow the medication prescribed by the doctor
g. The minerals and acid levels in the urine are controlled by medication which may
useful in people who is having certain kinds of stones.
 SUMBER
Guidelines on Urolithiasis
C. Trk (Chair), T. Knoll (Vice-chair), A. Petrik,
K. Sarica, A. Skolarikos, M. Straub, C. Seitz
2005 EuropeanAssociation of Urology 2015

Diagnosis and Initial Management of Kidney Stones

ANDREW J. PORTIS, M.D., and CHANDRU P. SUNDARAM, M.D.

Washington University School of Medicine, St. Louis, Missouri

Am Fam Physician. 2001 Apr 1;63(7):1329-1339.

Indian J Endocrinol Metab. 2012 Mar-Apr; 16(2): 236239.

doi: 10.4103/2230-8210.93741
PMCID: PMC3313741

Medical management of renal stone

Shriganesh R. Barnela, Sachin S. Soni,1,2 Sonali S. Saboo,1 and Ashish S. Bhansali3

Author information Copyright and License information

Research and Reviews Journal of Medical and Health Sciences

e-ISSN: 2319-9865 p-ISSN: 2322-0104

RRJMHS | Volume 5 | Issue 3 | September, 2016

Renal Calculus: A Brief Review

Sruthi Ratna Harika G1* and Kartheek Srinivas
Ch2

Renal Stone Disease: Causes, Evaluationand Medical Treatment Ita Pfeferman

HeilbergNestor Schor