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March 27, 1981, Vol 245, No. 12 >
ARTICLE | March 27, 1981

Metabolic Evaluation of Nephrolithiasis in Patients With Medullary Sponge Kidney FREE

Michael O'Neill, MD; Neil A. Breslau, MD; Charles Y. C. Pak, MD
[+] Author Affiliations

Reprint requests to Department of Internal Medicine, Southwestern Medical School, 5323 Harry Hines Blvd, Dallas, TX 75235 (Dr Breslau).


JAMA. 1981;245(12):1233-1236. doi:10.1001/jama.1981.03310370025016
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References

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.

(JAMA 1981;245:1233-1236)

REFERENCES

1 +
Lenarduzzi G:  Reperto pielografico poco commune (dilatazione della via urinarie intrarenali) . Radiol Med 1939;;26:346-347.
2 +
Cacchi R, Ricci V:  Supra una rara e forse ancora non descritta affezione cistica della pyramidi renali ('rene a spugna') . Atti Soc Ital Urol 1948;;5:59-63.
3 +
Abeshouse BS, Abeshouse GA:  Sponge kidney: A review of the literature and a report of five cases . J Urol 1960;;84:252-267.
4 +
Kuiper JJ:  Medullary sponge kidney , in Gardner KD Jr (ed): Cystic Diseases of the Kidney . New York, John Wiley & Sons Inc, 1976;, pp 151-171.
5 +
Ekstom T, Engfeldt B, Lagergren C, et al: Medullary Sponge Kidney . Stockholm, Almqvist & Wiksell, 1959;.
6 +
Granberg PO, Lagergren C, Theve NO:  Renal function studies in medullary sponge kidney . Scand J Nephrol 1971;;5:177-180.
7 +
Yendt ER, Jarzylo S, Finnis WA, et al:  Medullary sponge kidney (tubular ectasia) in calcium urolithiasis . Presented at the Fourth International Symposium on Urolithiasis Research, Williamsburg, Va, June 22-26, 1980 , pp 90-91.
8 +
Dlabal PW, Jordan RM, Dorfman SG:  Medullary sponge kidney and renal-leak hypercalciuria: A link to the development of parathyroid adenoma? JAMA 1979;;241:1490-1491.
9 +
Gremillion DH, Kee JW, McIntosh DA:  Hyperparathyroidism and medullary sponge kidney: A chance relationship? JAMA 1977;; 237:799-800.
10 +
Stella FJ, Massry SG, Kleeman CR:  Medullary sponge kidney associated with parathyroid adenoma . Nephron 1973;;10:322-336.
11 +
Rao DS, Frame B, Block MA, et al:  Primary hyperparathyroidism: A cause of hypercalciuria and renal stones in patients with medullary sponge kidney . JAMA 1977;;237:1353-1355.
12 +
McIlwaine CLK, Jolan KN:  Hyperparathyroidism associated with medullary sponge kidney . Br J Urol 1968;;40:202-205.
13 +
Pak CYC, Fetner C, Townsend J, et al:  Evaluation of calcium urolithiasis in ambulatory patients: Comparison of results with those of inpatient evaluation . Am J Med 1978;;64:979-987.
14 +
Pak CYC, Britton F, Peterson R, et al:  Ambulatory evaluation of nephrolithiasis: Classification, clinical presentation and diagnostic criteria . Am J Med 69:19-30, 1980;.
15 +
Pak CYC, Galosy RA:  Fasting urinary calcium and cyclic AMP: A discriminant analysis for the identification of renal and absorptive hypercalciurias . J Clin Endocrinol Metab 1979;; 48:260-265.
16 +
Pak CYC, Kaplan RA, Bone H, et al:  A simple test for the diagnosis of absorptive, resorptive, and renal hypercalciurias . N Engl J Med 1975;;292:497-500.
17 +
Pak CYC, Waters O, Arnold L, et al:  Mechanism for calcium urolithiasis among patients with hyperuricosuria: Supersaturation of urine with respect to monosodium urate . J Clin Invest 1977;;59:426-431.
18 +
Mayall GF:  The incidence of medullary sponge kidney . Clin Radiol 1970;;21:171-174.

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1 +
Lenarduzzi G:  Reperto pielografico poco commune (dilatazione della via urinarie intrarenali) . Radiol Med 1939;;26:346-347.
2 +
Cacchi R, Ricci V:  Supra una rara e forse ancora non descritta affezione cistica della pyramidi renali ('rene a spugna') . Atti Soc Ital Urol 1948;;5:59-63.
3 +
Abeshouse BS, Abeshouse GA:  Sponge kidney: A review of the literature and a report of five cases . J Urol 1960;;84:252-267.
4 +
Kuiper JJ:  Medullary sponge kidney , in Gardner KD Jr (ed): Cystic Diseases of the Kidney . New York, John Wiley & Sons Inc, 1976;, pp 151-171.
5 +
Ekstom T, Engfeldt B, Lagergren C, et al: Medullary Sponge Kidney . Stockholm, Almqvist & Wiksell, 1959;.
6 +
Granberg PO, Lagergren C, Theve NO:  Renal function studies in medullary sponge kidney . Scand J Nephrol 1971;;5:177-180.
7 +
Yendt ER, Jarzylo S, Finnis WA, et al:  Medullary sponge kidney (tubular ectasia) in calcium urolithiasis . Presented at the Fourth International Symposium on Urolithiasis Research, Williamsburg, Va, June 22-26, 1980 , pp 90-91.
8 +
Dlabal PW, Jordan RM, Dorfman SG:  Medullary sponge kidney and renal-leak hypercalciuria: A link to the development of parathyroid adenoma? JAMA 1979;;241:1490-1491.
9 +
Gremillion DH, Kee JW, McIntosh DA:  Hyperparathyroidism and medullary sponge kidney: A chance relationship? JAMA 1977;; 237:799-800.
10 +
Stella FJ, Massry SG, Kleeman CR:  Medullary sponge kidney associated with parathyroid adenoma . Nephron 1973;;10:322-336.
11 +
Rao DS, Frame B, Block MA, et al:  Primary hyperparathyroidism: A cause of hypercalciuria and renal stones in patients with medullary sponge kidney . JAMA 1977;;237:1353-1355.
12 +
McIlwaine CLK, Jolan KN:  Hyperparathyroidism associated with medullary sponge kidney . Br J Urol 1968;;40:202-205.
13 +
Pak CYC, Fetner C, Townsend J, et al:  Evaluation of calcium urolithiasis in ambulatory patients: Comparison of results with those of inpatient evaluation . Am J Med 1978;;64:979-987.
14 +
Pak CYC, Britton F, Peterson R, et al:  Ambulatory evaluation of nephrolithiasis: Classification, clinical presentation and diagnostic criteria . Am J Med 69:19-30, 1980;.
15 +
Pak CYC, Galosy RA:  Fasting urinary calcium and cyclic AMP: A discriminant analysis for the identification of renal and absorptive hypercalciurias . J Clin Endocrinol Metab 1979;; 48:260-265.
16 +
Pak CYC, Kaplan RA, Bone H, et al:  A simple test for the diagnosis of absorptive, resorptive, and renal hypercalciurias . N Engl J Med 1975;;292:497-500.
17 +
Pak CYC, Waters O, Arnold L, et al:  Mechanism for calcium urolithiasis among patients with hyperuricosuria: Supersaturation of urine with respect to monosodium urate . J Clin Invest 1977;;59:426-431.
18 +
Mayall GF:  The incidence of medullary sponge kidney . Clin Radiol 1970;;21:171-174.

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