Notably, as posited by Alelign and Petros (2018), there are different types and causes of stones forming in the urinary system. First, calcium oxalate stones are the most common accounting for approximately 80 % of the renal calculi cases. Struvite stones occur in patients with chronic urinary tract infection and account for roughly 10 to 15% (Alelign & Petros, 2018). Uric acid stones, on the other hand, are caused by foods containing high levels of purine and they mainly occur in people with gouty arthritis. Thirdly, cystine stones occur in less than 2% of the cases and are usually found in patients with an autosomal genetic disorder that makes them unable to transport the amino acids and cysteine (Alelign & Petros, 2018). Lastly, drug-induced stones are the least common ones (1%) and are induced by the intake of guaifenesin, atazanavir, triamterene, and sulfa drug.
From this explanation, it is clear that the presented patient mostly likely had calcium oxalate stones on his tract as he had no underlying comorbidities. Besides, his vital signs and laboratory result findings showed no sign of infection. The calcium stones ensue when urine is supersaturated with oxalate and calcium. Consequently, this causes precipitation of the solutes that lead to nucleation (Gupta & Shamsher, 2018). The resultant effect of this is crystal formation. In other words, the crystals congregate inside the renal pelvis or the collecting system, leading to the formation of large-sized stones.
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While discharging this patient, the following instructions will be appropriate. First, the patient should increase his daily fluid intake to around 2.5 liters and try as much as possible to take fluids after every episode of micturition (Han et al., 2015). Secondly, he should reduce the intake of foods high in animal protein, sodium, potassium, magnesium, vitamin C, and oxalates. Thirdly, it is vital to increase the uptake of fruits and vegetables in his diet. Besides, he should avoid the use of furosemide unless instructed by a doctor. Lastly, the patient should use painkillers and medications as prescribed and if the symptoms recur, he should go back to the health facility.
Lastly, the constant pain occurs due to the stretching of kidney capsules by the stones (Patti & Leslie, 2020). On the other hand, colicky pain is associated with the peristaltic movement of the smooth muscles on the genitourinary tract against the stone.
References
Alelign, T., & Petros, B. (2018). Kidney Stone Disease: An Update on Current Concepts. Advances in urology , 3068365. https://doi.org/ 10.1155/2018/3068365
Gupta, S., & Shamsher, S. K. (2018). Kidney stones: Mechanism of formation, pathogenesis and possible treatments. J Biomol Biochem , 2 (1), 1-5. https://www.pulsus.com/scholarly-articles/kidney-stones-mechanism-of-formation-pathogenesis-and-possible-treatments-4896.html
Han, H., Segal, A. M., Seifter, J. L., & Dwyer, J. T. (2015). Nutritional Management of Kidney Stones (Nephrolithiasis). Clinical nutrition research , 4 (3), 137-152. https://doi.org/10.7762/cnr.2015.4.3.137
Patti, L., & Leslie. S. W. (2020). Acute Renal Colic. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing . https://www.ncbi.nlm.nih.gov/books/NBK431091/
