- Urea splitting organisms include Proteus, Klebsiella, Pseudomonas, and Enterobacter
- Xanthogranulomatous pyelonephritis can occur in patients with chronic pyelonephritis with recurrent urinary tract infections causing accumulation of granulomatous tissue containing lipid-laden macrophages which can destroy a kidney. Usually this is unilateral and the treatment is nephrectomy. Look for a bear paw on CT!
| Kidney Stones | Composition | PH | Visibility on Xray |
| Calcium Stones (80%)
|
Calcium Oxalate 90%
Calcium Phosphate 10% |
Insoluble in Acidic pH (except Ca phosphate) | Radiopaque |
| Struvite (<10%) | Magnesium Ammonium Phosphate
Calcium Carbonate Apatite |
Insoluble in Alkaline PH | Radiopaque (but can be variable) |
| Uric Acid Stones (~10%) | Uric Acid Crystals | Insoluble in Acidic pH | Radiolucent |
| Cystine (rare) | Cystine (Congenital Cystinuria) | Insoluble in Acidic PH | Radiolucent |
SCVMC IM Chief Resident Blog 