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Faktor Eksogen Faktor lingkungan,pekerjaan,makanan,infeksi dan kejenuhan mineral dalam air minum 3. Faktor lain; a. Infeksi Infeksi saluran kencing dapat menyebabkan nekrosis jaringan ginjal dan akan menjadi inti pembentukan batu saluran kencing. Infeksi bakteri akan memecah ureum dan membentuk amonium yang akan mengubah pH urine menjadi alkali. Stasis dan Obstruksi urine Adanya obstruksi dan stasis urine akan mempermudah infeksi saluran kencing. Jenis kelamin Pria lebih banyak daripada wanita d. Ras Batu saluran kencing lebih banyak ditemukan di Afrika dan Asia. E.Keturunan Annggota keluarga batu saluran kencing lebih banyak mempunyai kesempatan. Air minum Memperbanyak diuresis dengan cara banyak minum air akan mengurangi kemungkinan terbentuknya batu,sedangkan kurang minum menyebabkan kadar semua substansi dalam urine meningkat g. Pekerjaan Pekerja keras yang banyak bergerak mengurangi kemungkinan terbentuknya batu daripada pekerja yang lebih banyak duduk. H.Suhu Tempat yang bersuhu panas menyebabkan banyak mengeluarkan keringat i. Makanan Masyarakat yang banyak mengkonsumsi protein hewani angka morbiditas BSk berkurang.Penduduk yang vegetarian yang kurang makan putih telur lebih sering menderita BSK ( buli-buli dan Urethra ) 4. Patogenesis Sebagian besar batu saluran kencing adalah idiopatik,bersifat simptomatik ataupun asimptomatik. Teori terbentuknya batu a. Teori Intimatriks Terbentuknya BSK. Memerlukan adanya substansi organik sebagai inti.Substansi ini terdiri dari mukopolisakarida dan mukoproptein A yang mempermudah kristalisasi dan agregasi substansi pembentukan batu. Teori Supersaturasi Terjadi kejenuhan substansi pembentuk batu dalam urine seperti; sistin,santin,asam urat,kalsium oksalat akan mempermudah terbentuknya batu. Teori Presipitasi-Kristaliasi Perubahan pH urine akan mempengaruhi solubilitas substasi dalam urine.Urine yang bersifat asam akan mengendap sistin,santin,asam dan garam urat,urine alkali akan mengendap garam-garam fosfat. Teori Berkurangnya faktor penghambat Berkurangnya faktor penghambat seperti peptid fosfat, pirofosfatpolifosfat, sitrat magnesium.asam mukopolisakarida akan mempermudah terbentuknya BSK. Pemeriksaan Diagnostik. Urinalisa; warna mungkin kuning,coklat gelap,berdarah,secara umum menunjukan SDM, SDP, kristal ( sistin,asam urat,kalsium oksalat), ph asam (meningkatkan sistin dan batu asam urat) alkali ( meningkatkan magnesium, fosfat amonium, atau batu kalsium fosfat), urine 24 jam:kreatinin, asam urat kalsium, fosfat, oksalat, atau sistin mungkin meningkat), kultur urine menunjukan ISK, BUN/kreatinin serum dan urine; abnormal (tinggi pada serum/rendah pada urine) sekunder terhadap tingginya batu obstruktif pada ginjal menyebabkan iskemia/nekrosis. Darah lengkap: Hb,Ht,abnormal bila psien dehidrasi berat atau polisitemia. Hormon Paratyroid mungkin meningkat bila ada gagal ginjal ( PTH. Merangsang reabsobsi kalsiumm dari tulang, meningkatkan sirkulasi s erum dan kalsium urine. Foto Rntgen; menunjukan adanya kalkuli atau perubahan anatomik pada area ginjal dan sepanjang urewter. IVP.: memberukan konfirmasi cepat urolithiasis seperti penyebab nyeri,abdominal atau panggul.Menunjukan abnormalitas pada struktur anatomik (distensi ureter). Sistoureterokopi;visualiasi kandung kemih dan ureter dapat menunjukan batu atau efek obstruksi. USG ginjal: untuk menentukan perubahan obstruksi,dan lokasi batu.: 7. Penatalaksanaan; a. Menghilangkan obstruksi b. Mengobati infeksi c. Menghilangkan rasa nyeri. Mencegah terjadinya gagal ginjal dan mengurangi kemungkinan terjadinya rekurensi 8. Komplikasi: a.Infeksi b.Obstruksi c.Hidronephrosis. 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