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staghorn calculus

A large urinary calculus within the renal pelvis (often shaped like a staghorn). Pathology: 1) associated with struvite stones (magnesium ammonium phosphate) 2) urinary tract infections including pyelonephritis are common - urea-splitting bacteria Proteus & Klebsiella are frequent pathogens - urea -> NH3 + CO2 thus they form in alkaline urine - less commonly Pseudomonas 3) calcium phosphate stone most common [2]; rarely form staghorn calculi [4] Complications: - struvite stones leading to staghorn calculus resulting from Pseudomonas infection can lead to sepsis & ESRD [3] Management: - stone removal - antibiotic therapy

General

struvite (magnesium ammonium phosphate) stone nephrolithiasis; kidney stone

References

  1. UCLA Intensive Course in Geriatric Medicine & Board Review, Marina Del Ray, CA, Sept 12-15, 2001
  2. Viprakasit DP, Sawyer MD, Herrell SD, Miller NL. Changing composition of staghorn calculi. J Urol. 2011 Dec;186(6):2285-90. PMID: 22014820
  3. Medical Knowledge Self Assessment Program (MKSAP) 19. American College of Physicians, Philadelphia 2021
  4. NEJM Knowledge+ Nephrology/Urology