#EMConf: Kidney Stones

 Who gets CT?

  • Avoid ordering CT of the abdomen and pelvis in young otherwise healthy emergency department (ED) patients (age <50) with known histories of kidney stones presenting with symptoms consistent with uncomplicated renal colic.
  • If you do a CT in an older person (>50), you’ll find another source of the pain ~30% of the time


Who gets BMP?

  • Single kidney + Concern for infection; Even if obstruction, other kidney can compensate


Who gets admitted?

  • Stone + Infection
  • AKI
  • One Kidney/ Transplant
  • Intractable symptoms
  • Stone > 10 mm; Urology guidelines recommend admission. 


Outpatient Management

  • Strainer for collection and to see if stone passed
  • urology follow up + NSAIDS + return precautions
  • +/- Flomax: ?benefit for > 6 mm but beware of dizziness and orthostatic hypotension


Will I get another stone?  

  • 75% will get another in 20 years: 40% will get repeat in 1 year


Iced Tea caused my stones?

  • Iced tea does not cause kidney stones, this is a misconception in general public
  • Lifestyle modification: control sugar + lose weight + reduce sodium.