Nephrolithiasis in Medullary Sponge Kidney: Evaluation of Clinical and Metabolic Features

McPhail, E. Fred; Gettman, Matthew T.; Patterson, David E.; Rangel, Laureano J.; Krambeck, Amy E.

doi:10.1016/j.urology.2011.07.1414

Cited by 28 publications

(27 citation statements)

References 20 publications

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“…MSK is classically known to be a benign condition that is incidentally found on renal imaging; however, since it has been strongly associated with various conditions that demand clinical attention, its diagnosis is important. MSK patients are known to have a high risk of renal nephrolithiasis [2], a condition that has been shown to increase the long-term risk of CKD [3]. MSK patients have also been reported to have reduced renal tubular function [4], a higher risk of urinary tract infections (UTIs), reduced bone density [5], and distal renal tubular acidosis (dRTA) [6].…”

Section: Introductionmentioning

confidence: 99%

“…However, a subset of MSK patients are clinically silent [2] and the diagnosis is incidentally picked up on renal imaging for other indications. The strong association of MSK with nephrolithiasis, especially calcium stones [12], is explained by the tendency of urinary stasis in the ectatic collecting ducts and the association of high quantities of stone promoters like hypercalciuria [13] and reduced levels of inhibitors like citrate and magnesium [14] in the urine.…”

Section: Introductionmentioning

confidence: 99%

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CT Urography for the Diagnosis of Medullary Sponge Kidney

Koraishy

Ngo²,

Israel³

2014

Am J Nephrol

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Background: Medullary sponge kidney (MSK) is characterized by malformation of the terminal collecting ducts and is associated with an increased risk of nephrolithiasis, nephrocalcinosis, urinary tract infections, renal acidification defects, and reduced bone density. It has been historically diagnosed with intravenous pyelography (IVP), which is falling out of favor as an imaging modality. CT urography (CTU) performed with multidetector CT (MDCT) has been shown to create images of the renal collecting system with similar detail as IVP; however, its utility in diagnosing MSK has not been defined. Case Report: We present the first 15 patients with recurrent symptomatic nephrolithiasis who were evaluated in our renal stone clinic with CTU. Four patients were diagnosed with MSK after visualization of the characteristic radiologic findings. Discussion: CTU effectively demonstrates the characteristic radiologic findings of MSK including collecting tubule dilatation, medullary nephrocalcinosis, nephrolithiasis, and medullary cysts. Dose reduction protocols can reduce radiation exposure below that associated with conventional IVP. We propose CTU be considered for the diagnosis of MSK.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

CT Urography for the Diagnosis of Medullary Sponge Kidney

Koraishy

Ngo²,

Israel³

2014

Am J Nephrol

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“…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 [9]. IVU is the gold standard for the diagnosis of MSK, but as the technique is used less and less, there is a concrete possibility of this renal condition being forgotten in the future.…”

Section: Discussionmentioning

confidence: 99%

Medullary Sponge Kidney with Incomplete Renal Tubular Acidosis: A Poorly Understood Disease

Gupta¹,

Jain²,

Chandra³

et al. 2016

JCR

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Abstract:Medullary sponge kidney (MSK) is usually a benign process which may remain asymptomatic and undetected for life. Incomplete distal renal tubular acidosis (RTA) may be found in as many as 30% to 40% of these patients. Clinical presentation usually occurs after 20 years of age. It may present with renal colic, recurrent urinary tract infection (UTI) and gross hematuria. We are presenting a case of 30 year old female who presented with recurrent urinary tract infection, underwent multiple surgeries for renal stone and due to insufficient follow up developed complications related to forgotten ureteric stent. She finally landed up as poorly functioning symptomatic right kidney and non-functioning left kidney for which nephrectomy was done. This case highlights the importance of earlier diagnosis, proper management and frequent follow up to preserve renal function in a case of MSK.

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“…Radiological evaluation will also reveal anatomical anomalies responsible for or associated with stone disease, either by inducing stasis, facilitating infection or preventing stone expulsion, some of which may be amenable to surgical correction. Sponge kidney is the most frequent one and is defined by the dilatation of precalicial tubules [25]. Other anomalies include horseshoe kidneys, ureteropelvic junction syndrome, or reflux [26].…”

Section: Radiologic Evaluationmentioning

confidence: 99%