Medullary Sponge Kidney and Urinary Calculi: Aeromedical Concerns

Abstract

Abstract:Medullary Sponge Kidney (MSK) is a benign disorder associated with renal stones in 60% of patients. Patients frequently have episodic painless hematuria but are otherwise asymptomatic unless renal calculi or infections complicate the disease. Nephrolithiasis is a relative, but frequently enforced, contraindication to space or other high performance flight.Two case reports of asymptomatic NASA flight crew with MSK and three cases of military aviators diagnosed with MSK are reviewed, all cases resulted in waiver and return to flight status after treatment and a vigorous follow up and prophylaxis protocol. MSK in aviation and space flight necessitates a highly case-by-case dependent evaluation and treatment process to rule out other potential confounding factors that might also contribute to stone formation and in order to re-qualify the aviator for flight duties.

The kidney, volume homeostasis and osmoregulation in space: current perspective and knowledge gaps

“…Changes in the microarchitecture of the kidney can lead to abnormal renal calcification and stones (e.g. in medullary sponge kidney), and changes in the nephron architecture can occur with the kinds of electrolyte disturbance that can be caused by space flight 78 , 79 .…”