Medullary Sponge Kidney (Tubular Ectasia) in Calcium Urolithiasis

Experience Using Extracorporeal Shock-Wave Lithotripsy to Treat Urinary Calculi in Problem Kidneys

“…Its reported incidence in patients with urolithiasis ranges from 17 to 33% and these patients are predominantly women [10][11][12], PCK disease is characterized by genetic transmission and a diffuse, bilateral, progressive cystic deformity of the kidneys. Renal calculi are not rare in association with PCK disease [13].…”

Nephrolithiasis and Nephrocalcinosis

“…Papillary nephrocalcinosis implies stones or calcification in areas of papillary injury or anatomic distortion, as in medullary sponge kidney (11). Patchy cortical nephrocalcinosis usually implies prior tissue injury or hypercalcemia.…”

“…One study, drawn from a community urology practice (16), demonstrated that 50% of people who formed one stone formed another by 8 years, regardless of age or gender. In two prospective studies, most people (11,17) who had formed one stone ultimately formed another (Table 4). Given this fact, we suspect that a solitary stone deserves investigation.…”

“…Small stones form in the collecting ducts, leading to papillary nephrocalcinosis (57). Hypercalciuria is frequent in medullary sponge kidney (MSK) and has been viewed as a possible consequence of the tubule defect (11). Cases of primary hyperparathyroidism and MSK have been described in which renal hypercalciuria has been thought to lead to secondary parathyroid stimulation and, ultimately, an adenoma (58).…”

Management of Lithiasis in Medullary Sponge Kidneys

“…The incidence of MSK in the general popula tion is calculated to be 0.5% and the incidence among patients with renal lithiasis to be 21% [7,8], It has been shown that urine alkalization may reduce the incidence of stone formation in these patients. The increased inci dence of stone formation in patients with MSK increases the risk of spontaneous stone passage and obstructive uropathy.…”