Symptoms and Treatments of Medullary Sponge Kidneys

Medullary sponge kidney is a congenital and benign renal disorder affecting renal medullary areas and many scholars regard it as congenital malformation of renal medulla.

Though medullary sponge kidney is not hereditary, there have been reports of familial onset of the disease. Generally the kidney functions will not be affected and many patients have clinical symptoms between 40 to 50 years old and it is more common among men.

The progression of medullary sponge kidney is slow and in the early stage there is no symptom in clinic. The common symptoms are recurrent gross or microscopic hematuria, urinary tract infections, back pain, renal colic and kidney stones and a few cases might have painless gross hematuria. The clinical symptoms are caused by the retention of urine due to the dilation of the collecting tubules, bleeding or stones in the kidneys and ureter. In case of urinary tract infections, there can be pyuria. Though the glomerular filtration rate and renal concentration ability will decrease and there will be dysfunction of urinary acidification and renal tubular acidosis, the renal functions usually are normal and few will develop into end stage renal failure. Those that have progressed into end stage renal disease will have anemia, loss of sodium and azotemia. There are about 59% medullary sponge kidney patients will have hypercalciuria.

Treatments for medullary sponge kidney mainly aim at treating complications.

1. General treatments include supplement of sodium, calcium and vitamin E, blood transfusion.

2. Treatments for kidney stone. There is at present no method to avoid the formation of stones. Patients should drink more water and maintain daily urine output of 2000ml to reduce the deposition of calcium salts. The combination of Chinese therapy and western therapy can help discharge stones and at the same time protect kidney functions.

3. Prevention and treatments for infections. Choose the sensitive antibiotics.

4. Surgery. Since medullary sponge kidney usually affects bilateral kidneys, it is not recommended to have surgery. If it can be confirmed that the disease is unilateral or segmental and the other kidney has normal functions, nephrectomy or renal resection can be considered.