Document Detail


Nephrolithiasis in medullary sponge kidney: evaluation of clinical and metabolic features.
MedLine Citation:
PMID:  22014971     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Medullary sponge kidney (MSK) is a disorder characterized by tubular dilation of renal collecting ducts and cystic dilation of medullary pyramids that has been associated with stone disease. The significance of nephrolithiasis and the mechanisms by which it occurs are incompletely understood. We describe clinical and metabolic features of nephrolithiasis in a cohort of patients with MSK.
METHODS: Records were reviewed of 56 patients, all with radiographic diagnosis of medullary sponge kidney and data collected pertaining to presentation, stone events and recurrences, stone composition, and metabolic profile to perform a descriptive study with median 3.7 years follow-up.
RESULTS: Nephrolithiasis was confirmed radiographically in 39/56 patients (69.6%). No patient without evidence of nephrolithiasis developed a stone event, whereas 13/39 (33%) of those with nephrolithiasis developed a recurrent stone event. Stones were composed of calcium oxalate monohydrate, calcium oxalate dihydrate, calcium phosphate apatite, and uric acid. Metabolic profile was obtained for 26 of 39 (67%) stone-forming patients demonstrating abnormalities in 22/26 (84.6%). These included hypercalciuria, 58% (15/26); low urine volume, 35% (9/26); hyperuricosuria, 27% (7/26); hypocitraturia, 19% (5/26); elevated urine sodium, 15% (4/26); and hyperoxaluria, 12% (3/26).
CONCLUSION: Many patients with MSK have no evidence of nephrolithiasis. Among those who do, recurrence is common, and metabolic profile and composition are varied as in the general stone-forming population.
Authors:
E Fred McPhail; Matthew T Gettman; David E Patterson; Laureano J Rangel; Amy E Krambeck
Publication Detail:
Type:  Journal Article     Date:  2011-10-19
Journal Detail:
Title:  Urology     Volume:  79     ISSN:  1527-9995     ISO Abbreviation:  Urology     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-02-07     Completed Date:  2012-05-17     Revised Date:  2013-01-22    
Medline Journal Info:
Nlm Unique ID:  0366151     Medline TA:  Urology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  277-81     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Elsevier Inc. All rights reserved.
Affiliation:
Department of Urology, Mayo Clinic, Rochester, Minnesota 55905, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Citric Acid / urine
Diuresis
Female
Humans
Hypercalciuria / complications
Hyperoxaluria / complications
Kidney Calculi / chemistry
Male
Medullary Sponge Kidney / complications*,  metabolism,  radiography
Middle Aged
Natriuresis
Nephrolithiasis / blood,  etiology*,  radiography
Recurrence
Retrospective Studies
Uric Acid / urine
Young Adult
Chemical
Reg. No./Substance:
69-93-2/Uric Acid; 77-92-9/Citric Acid
Comments/Corrections
Comment In:
Urology. 2012 Dec;80(6):1395-6   [PMID:  23206796 ]

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