Ultrasound to address medullary sponge kidney: a retrospective study

BMC Nephrology

Roberto Giacosa¹  Augusto Vaglio²  Sara Giuliotti³  Dario Moretto⁴  Isabella Pisani⁴  Chiara Cantarelli⁴  Enrico Fiaccadori⁴  Lucio Manenti⁴  Giuseppe Regolisti⁴ 

[1] Casa di Cura Città di Parma, Unit of Diagnostic, Contrast enhanced and Interventional Ultrasound;Department of Biomedical Experimental and Clinical Sciences “Mario Serio”, University of Firenze;Struttura complessa di Radiologia, Azienda Ospedaliero-universitaria di Parma;U.O. Nefrologia, Azienda Ospedaliero-Universitaria di Parma, Dipartimento di Medicina e Chirurgia, Università di Parma;

关键词: Renal cystic disease;    Ultrasonography;    Medullary sponge kidney;    Nephrolithiasis;    Chronic renal failure;   

DOI  :  10.1186/s12882-020-02084-1

来源: DOAJ

【 摘 要 】

Abstract Background Medullary sponge kidney (MSK) is a rare disease characterized by cystic dilatation of papillary collecting ducts. Intravenous urography is still considered the gold standard for diagnosis. We identified a cohort of patients from our outpatient clinic with established diagnosis of MSK to outline some ultrasonographic characteristics that may help establish a diagnosis. Methods We conducted a retrospective study of patients seen between January 1st 2009 and January 1st 2019 in our clinic. Out of 4321 patients, 18 had a diagnosis of MSK. We reviewed their clinical and family history, laboratory data and imaging studies. Specifically, we focused on ultrasound imaging. Results Patients were referred to our outpatient clinic because of renal impairment (44%), family history of nephropathy (17%), nephrolithiasis or an established diagnosis of MSK (39%). Seventy-two percent of patients presented with chronic kidney disease, 22% required hemodialysis. Urinary tract infections (44%), nephrolithiasis (33%), microscopic hematuria (50%) and proteinuria (44%) were reported. Seven patients underwent computed tomography; all of them received ultrasound. Ultrasound examination showed bilateral renal cysts, usually small and located in the renal medulla, and microcalcifications located in the medulla or within the cysts. Conclusion We identified a peculiar tetrad associated with MSK: 1) hypoechoic medullary areas, 2) hyperechoic spots, 3) microcystic dilatation of papillary zone, 4) multiple calcifications (linear, small stones or calcified intracystic sediment) in each papilla. The presence of this diagnostic tetrad, added to laboratory data and clinical history, could be helpful in the differential diagnosis to identify patients with MSK.

【 授权许可】

Unknown