Medullary Sponge Kidney

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Medullary sponge kidney is rare kidney disease that affects approximately 1 in every 200 persons. Although some cases of this disorder seem to be inherited, usually the cause is not known. Basically, this disease causes pools of urine to remain in the kidneys.

The main function of the kidneys is to excrete waste products from the body in the form of urine. As the blood moves through the kidneys, unwanted substances are removed. This job is mainly performed by the nephrons. Once the waste substances are removed from the blood they more down tiny collecting tubules toward the ureters (ducts that carry urine from the kidney to the bladder). These tiny tubules gradually join together until they reach the renal pelvis, where the ureters begin. As the tubules join, they are supposed to get progressively bigger as they get fewer in number. This is not the case with persons with medullary sponge kidney. The tubules are irregular in diameter, forming pools of urine along the way. These pools encourage stone formation and kidney infection.

Symptoms

There are little or no symptoms directly related to this condition. The symptoms associated with medullary sponge kidney are those related to infection and stone passage. Infection causes fever; back and flank pain; cloudy, frequent, and burning urine; and general discomfort. Stones cause pain in the flank or groin as they pass. They usually cause some bleeding. The bleeding may not be visible in the urine, but it is apparent under a microscope.

Diagnosis & Treatment

In most cases, this condition is only diagnosed after a patient is affected with recurring kidney infections, bleeding, or kidney stones. This will prompt the physician to check for sponge kidney condition. A series of x-rays taken after injecting iodine dye into a vein usually reveals the disorder, characterized by tubules that are irregular in diameter. This procedure is known as intravenous pyelogram (IVP). The dye is like a highlighter which makes it easier to see the anatomy of the kidney.

Many people never have trouble with this disorder. For those that do, however, the primary treatment relates to kidney infections and kidney stones. Infections are usually treated with antibiotics early in order to prevent kidney damage. Sometimes, kidney stones pass out in the urine without medical intervention. If, however, they do not pass out on their own, they may need to be surgically removed. Often, removal can be accomplished without an incision but rather by reaching up with instruments through the lower urinary tract to grab the stones. There is also a new method of stone treatment called shock wave lithotripsy. A special machine delivers a focused blast of shock waves that breaks stones into sand so that they will pass out naturally. It is considered reasonably safe and usually effective.

Persons with medullary sponge kidney should constantly monitor their health for early signs of kidney infections or kidney stones. This will allow for early treatment that provides the best long-term results. Kidney infection and kidney stones can result in progressive damage to the kidneys and ultimate kidney failure. By drinking extra liquids, most stones can be prevented. The most common kind of stones, calcium stones, can be deterred by regularly taking a medication that encourages urine production (thiazide diuretic).

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