kidney stones: when to consult urology?

11 Jul

Urgent urologic consultation is needed for patients with:

  • acute kidney injury,
  • anuria,
  • intractable pain,
  • intractable nausea or vomiting,
  • patients with sepsis of urinary origin.

 

Also, stones >5mm are less likely to pass on their own, so urology consultation is worth considering.

 

Consultation would still be appropriate (or at least discussion with urology team) in patients with UTIs without sepsis plus kidney stones but often outpatient management with PO antibiotics may be favored if these stones are non-obstructing and smaller, with urology clinic follow up.

 

Submitted by J. Stone.

 

References: UpToDate: Diagnosis and acute management of suspected nephrolithiasis in adults; Tintinalli’s Emergency Medicine Chapter 97 Urologic Stone disease; picture

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