When is inpatient care indicated for nephrolithiasis?

Updated: Jun 21, 2018
  • Author: Chirag N Dave, MD; Chief Editor: Bradley Fields Schwartz, DO, FACS  more...
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Answer

The decision to hospitalize a patient with a stone is usually made based on clinical grounds rather than on any specific finding on a radiograph. Generally, hospitalization for an acute renal colic attack is now officially termed an observation because most patients recover sufficiently to go home within 24 hours. The admission rate for patients with acute renal colic is approximately 20%.

Hospital admission is clearly necessary when any of the following is present:

  • Oral analgesics are insufficient to manage the pain.

  • Ureteral obstruction from a stone occurs in a solitary or transplanted kidney.

  • Ureteral obstruction from a stone occurs in the presence of a urinary tract infection (UTI), fever, sepsis, or pyonephrosis.


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