A Clinical Observation on Renal Calculi

Kim, Jung Kwon; Min, Byung Kap

Abstract

A clinical observation was made on 97 patients of renal calculi who were admitted to the Department of Urology, Chonam University Medical School during the 5 years period from January, 1976 to December, 1980. The following results were obtained. 1) The incidence of renal calculi in 97 patients was 38.0% of urolithiasis in 255 patients and 6.8% of 1430 inpatients. The was an increasing tendency of incidence of renal calculi with annual increasing number of inpatients. 2) There were 51 male and 46 female, a ratio of 1.1:1. The age of two thirds patients of renal calculi ranged from 31 to 50 years, with peak age incidence in the fifth decade. 3) Definite past history of urinary calculi was found in 23 cases (23.7%). 4) The clinical symptoms on admission were flank pain in 92.8%, hematuria in 15.4%, frequency in 5.1% and suprapubic pain in 4.1%. 5) Urinalysis revealed hematuria in 77.3%, proteinuria in 54.1%, pyuria in 42.3%, bacteriuria in 28.9% crystalluria in 9.3% and normal in 8.2% 6) There were 42 renal units of right renal stone and 39 renal units of left renal stone with a ratio of 1.1:1. Unilateral renal calculi were found in 81 patients (83.5%). 7) Treatment consisted of pyelolithotomy in 51 patients (52.6%), pyelonephrolithotomy in 11 patients (11.3%), nephrectomy in 4 patients (4.1%) and nephrolithotomy in 3 patients (3.1%) in order. 8) The incidence of stone ranged from 1.1 to 4.0 gm in weight was 50.6%. The mean weight of removed renal calculi was 25.8 gm in nephrectomy, 19.0 gm in pyelonephrolithotomy, 5.7 gm in nephrolithotomy and 4.9 gm in pyelolithotomy. 9) A nephrostomy tube extended into the upper ureter was located in 30 cases (30.9%) and there was no difference in duration of nephrostomy tube inlaying between pyelolithotomy and pyelonephrolithotomy. 10) Postoperative complications were observed in 22 cases (26.2%) and the most common one was remnant stones in 6 cases (27.4%), of which 5 cases had multiple stones overweighed 10.0 gm. 11) The chemical analysis of 43 renal calculi showed calcium oxalate in 14 cases (32.6%), calcium phosphate in 78 cases (16.3%), the mixed type of calcium oxalate and calcium phosphate in 6 cases (14.0%) and the mixed type of calcium oxalate and magnesium phosphate in 5 cases (11.6%). There were 24 single chemical component of stones. As a result, oxalate stone (67.5%) and phosphate stone (55.9%) were prevalent.