Seventeen patients with documented medullary sponge kidney and nephrolithiasis underwent metabolic evaluation. These patients constituted 3.6% of our stone-forming population. Fifteen (88%) of 17 were hypercalciuric. The most common abnormality was absorptive hypercalciuria, occurring in 59%. Only three patients (18%) had renal hypercalciuria. None of the patients had primary hyperparathyroidism. Hyperuricosuria occurred together with hypercalciuria in five patients. In two patients, the precise cause of hypercalciuria could not be determined, and in another two patients, no metabolic abnormality could be detected. Thus, the patients with medullary sponge kidney and renal stones had the same spectrum of metabolic abnormalities as the overall population of stone formers. While these patients may theoretically have a greater anatomic propensity to form stones because of their anatomic abnormality, they should be evaluated and treated appropriately for any metabolic defect.

Cis-platinum as single agent therapy was investigated in 8 patients with stage D transitional cell carcinoma of the bladder. Dramatic responses were obtained in some patients and the quality of life was improved for as long as 8 months but no cures were obtained. Also noted was an occasional marked loss of renal function as measured by creatinine clearance despite a carefully managed protocol to avert this known side effect of cis-platinum (nephrotoxicity). No auditory problems were noted in these 8 patients.