8/31/15 Morning Report – Staghorn Calculi and Proteus Pyelonephritis!

  • 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

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s