Calcium phosphate calculi

stone

1. NUR FARRA NAJWA BINTI ABDUL AZIM 082015100035 CALCIUM PHOSPHATE CALCULI

2. OBJECTIVES At the end of the seminar, students should be able to List various type renal calculi List the frequency of each renal calculi Explain the etiology of calcium phosphate stone Describe the shape and colour of calcium phosphate stone

3. INTRODUCTION Calcium phosphate calculi is kidney stone Hardened minerals deposited in kidney Nephrolithiasis , renal stone diseases The kidneys filter waste products and add them to the urine. When waste materials in the urine do not dissolve completely, crystals and kidney stones may form. Stones may pass out of the kidney, lodged in the tube that carries urine from the kidney to the bladder ( ureter ). A lodged stone can block the flow of urine, causing pressure to build in the affected ureter and kidney.

4. CALCIUM PHOSPHATE CALCULI

5. VARIOUS RENAL STONE Kidney stone form when urine contains more crystal froming substances Calcium Oxalates Uric acid Or due to lack of substances that prevent crystal fom sticking together Chemical composition of stone depends on chemical imbalance in urine Most common Calcium oxalates Calcium phosphate Uric acid Struvite Cystine

6. CALCULI FREQUENCY

7. PATHOPHYSIOLOGY Approximately 85 percent of stones are composed predominantly of calcium compounds. The most common cause of calcium stone production is excess calcium in the urine ( hypercalciuria ) and normocalciuria Extra calcium is normally removed from the blood by the kidneys and excreted in the urine. In hypercalciuria , excess calcium builds up in the kidneys and urine, where it combines with other waste products to form kidney stones. Excess calcium Phosphate Calcium phosphate stone

8. Low levels of urinary citrate and magnesium, high levels of oxalate, sodium and uric acid, and inadequate urinary volume may also cause calcium stone formation. Calcium stones are composed of calcium that is chemically bound phosphate (calcium phosphate). Calcium phosphate stones typically occur in patients with metabolic or hormonal disorders such as Hyperparathyroidism and Renal tubular acidosis.

9. CAUSES Hypercalciuria Increased intestinal absorption of calcium (absorptive hypercalciuria ) excessive hormone levels (hyperparathyroidism, hypervitaminosis D) renal calcium leak (kidney defect that causes excessive calcium to enter the urine) Prolonged inactivity also increases urinary calcium and may cause stones. (This is why astronauts in space tend to lose bone mass and form kidney stones.) Renal tubular acidosis (inherited condition in which the kidneys are unable to excrete acid) significantly reduces urinary citrate (a natural urinary antacid) as well as total urinary acid levels and can lead to stone formation, usually calcium phosphate.

10. Animal protein may also raise the risk of calcium stone by increasing the excretion of calcium and reducing excretion of citrate into urine. Citrate prevent kidney stone but acid in animal protein reduces citrate in urine In prolonged immobilization the bone will turn over creates hypercalciuria (bone will demineralized) Sodium often from salt, causes kidney to excrete more calcium into urine, hence it will combine with oxalates and phosphorus to form stone. CONT.

11. STONE SHAPE AND COLOUR Smooth , round , yellow orange in colour appearance Dirty white Radio-opaque in radiograph Calcium phosphate stone greatest density

12. Calcium supplements  are also associated with a slight risk of kidney stones. However, consuming  too little calcium from food  can promote kidney stone development. Since the most common type of kidney stone is formed from calcium combined with oxalate or phosphate, it may seem counter-intuitive to eat calcium-rich foods. However, when consumed, calcium binds with oxalate and leaves the body through the stool. When oxalate doesn't have enough calcium to bind with, it builds up in the bloodstream and enters the urine, where it can cause stones.

13. SUMMARY

14. REFERENCES http://www.healthcommunities.com/kidney-stones/treatment.shtml