Role of kidney stones in renal pelvis flow

TL;DR

This study uses three-dimensional simulations to analyze how kidney stones influence flow patterns in the renal pelvis, revealing their role in trapping or washing out stones and affecting fluid dynamics during surgical procedures.

Contribution

It extends previous two-dimensional models by incorporating 3D flow and rigid stones, providing new insights into vortex interactions and flow circulation in the renal pelvis.

Findings

Stones can be washed out or trapped by vortical flow structures.

Presence of stones increases vorticity within the renal cavity.

Flow dynamics are significantly altered by multiple stones.

Abstract

We examine the time-dependent flow dynamics inside an idealised renal pelvis in the context of a surgical procedure for kidney stone removal, extending previous work by Williams et al. (2020,2021), who showed how vortical flow structures can hinder mass transport in a canonical two-dimensional domain. Here, we examine the time-dependent evolution of these vortical flow structures in three-dimensions, and incorporate the presence of rigid kidney stones. We perform direct numerical simulations, solving the transient Navier-Stokes equations in a spherical domain. The results shed light on the crucial role of flow circulation in the renal cavity and its effect on the trajectories of rigid stones. We demonstrate that stones can either be washed out of the cavity along with the fluid, or be trapped in the cavity via their interaction with vortical flow structures. Additionally, we study the effect of multiple stones in the flow field within the cavity in terms of the kinetic energy, entrapped fluid volume, and the clearance rate of a passive tracer modelled via an advection--diffusion equation. We demonstrate that the flow in the presence of stones features a higher vorticity production within the cavity compared with the stone-free cases.