An important factor contributing to renal calculi is?

HPSSC - 2015

Medical Surgical Nursing

Easy

Appeared in: HPSSC - 2015

Explanation

Hyperparathyroidism is a condition where the parathyroid glands produce too much parathyroid hormone (PTH).
Elevated PTH levels cause calcium to be leached from the bones into the bloodstream, resulting in hypercalcemia (high blood calcium).
The kidneys attempt to excrete this excess calcium, leading to hypercalciuria (high calcium levels in the urine).
This supersaturation of urine with calcium is a primary cause for the formation of calcium-based stones, which account for approximately 70% of all renal calculi.

Option A: While hypertension is often seen in patients with kidney stones, it is not a primary cause of stone formation. The link is considered correlational rather than causative.
Option B: Renal tumors do not metabolically produce stones. They are abnormal growths.
Option C: Nephrotic syndrome is characterized by massive proteinuria, hypoalbuminemia, and edema. Its pathophysiology is related to glomerular damage and protein loss, not the metabolic imbalances that cause most kidney stones.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Etiology and risk factors for renal calculi (kidney stones) as background academic context rather than a clinical decision trigger.
Nurses caring for patients with hyperparathyroidism must monitor for signs of renal calculi, such as flank pain, hematuria, and symptoms of a UTI.
Patient education is a key nursing intervention, focusing on increasing fluid intake to 2-3 liters per day to dilute urine and prevent stone formation.
Monitoring serum calcium levels is essential in patients with hyperparathyroidism to assess the risk of complications like kidney stones and to evaluate the effectiveness of treatment.

How to Approach the Question

First, identify the core concept of the question, which is to find a major cause of renal calculi (kidney stones).
Recall the main types of kidney stones. The most common type is composed of calcium.
Evaluate each option based on its physiological effect on the body, particularly on mineral and electrolyte balance.
Analyze Hyperparathyroidism: It directly impacts calcium metabolism by increasing PTH, which elevates blood and urine calcium levels, creating the perfect environment for calcium stone formation.
Analyze the other options: Hypertension is a risk factor for kidney disease but not a direct cause of stones. Renal tumors can cause obstruction (a secondary factor). Nephrotic syndrome involves protein loss, which is unrelated to the primary metabolic pathways of stone formation.
Conclude that hyperparathyroidism is the most direct and significant causative factor among the choices provided.

Concept Tested & Keywords

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E6 Pathology- ROBBINS & COTRAN PATHOLOGIC BASIS OF DISEASE 10TH Ed p. 947-949

E6 Medicine Davidson Principles Practice 24e p. 682-684