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Complete staghorn calculus in polycystic kidney disease: infection is still the cause.

Mao Z, Xu J, Ye C, Chen D, Mei C - BMC Nephrol (2013)

Bottom Line: Kidney stones in patients with autosomal dominant polycystic kidney disease are common, regarded as the consequence of the combination of anatomic abnormality and metabolic risk factors.We report a case of complete staghorm calculus in a polycystic kidney disease patient induced by repeatedly urinary tract infections.This 37-year-old autosomal dominant polycystic kidney disease female with positive family history was admitted in this hospital for repeatedly upper urinary tract infection for 3 years.

View Article: PubMed Central - HTML - PubMed

Affiliation: Kidney Institute of CPLA, Division of Nephrology, Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai 200003, China. maozhiguo93@gmail.com

ABSTRACT

Background: Kidney stones in patients with autosomal dominant polycystic kidney disease are common, regarded as the consequence of the combination of anatomic abnormality and metabolic risk factors. However, complete staghorn calculus is rare in polycystic kidney disease and predicts a gloomy prognosis of kidney. For general population, recent data showed metabolic factors were the dominant causes for staghorn calculus, but for polycystic kidney disease patients, the cause for staghorn calculus remained elusive.

Case presentation: We report a case of complete staghorm calculus in a polycystic kidney disease patient induced by repeatedly urinary tract infections. This 37-year-old autosomal dominant polycystic kidney disease female with positive family history was admitted in this hospital for repeatedly upper urinary tract infection for 3 years. CT scan revealed the existence of a complete staghorn calculus in her right kidney, while there was no kidney stone 3 years before, and the urinary stone component analysis showed the composition of calculus was magnesium ammonium phosphate.

Conclusion: UTI is an important complication for polycystic kidney disease and will facilitate the formation of staghorn calculi. As staghorn calculi are associated with kidney fibrosis and high long-term renal deterioration rate, prompt control of urinary tract infection in polycystic kidney disease patient will be beneficial in preventing staghorn calculus formation.

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CT images of a complete staghorn calculus in the right kidney in an ADPKD female. Above the staghorn calculus and polycystic kidney in the coronal plane; Below the three-dimension reconstructed CT image of calculus and kidney.
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Figure 1: CT images of a complete staghorn calculus in the right kidney in an ADPKD female. Above the staghorn calculus and polycystic kidney in the coronal plane; Below the three-dimension reconstructed CT image of calculus and kidney.

Mentions: One week before admission, this patient’s urinary irritation relapsed with high fever. As oral antibiotics were not responsive, she was admitted in this hospital for further treatment. On admission, her temperature was 39.0°C, blood pressure 110/82 mmHg. Physical examination revealed the bilateral enlarged kidneys that were palpable, tenderness existed in right flank area. Full blood cell count showed white blood cell count 11.1 × 109/l, hemoglobin 12.3 g/dl and platelets 157 × 109/l. A serum biochemical profile showed her renal function was normal with serum creatinine 0.74 mg/dl. Liver function and electrolytes were unremarkable. Urinalysis revealed +3 leukocytes, +2 blood, and +1 albumin. Chest radiology and electrocardiography were reported to be normal. Abdominal CT scan showed enlarged cystic kidneys and a complete staghorn calculus in the right kidney with no obvious signs of urinary tract obstruction (Figure 1). Wide spectrum antibiotics was administered intravenously and the symptoms relieved in 3 days.


Complete staghorn calculus in polycystic kidney disease: infection is still the cause.

Mao Z, Xu J, Ye C, Chen D, Mei C - BMC Nephrol (2013)

CT images of a complete staghorn calculus in the right kidney in an ADPKD female. Above the staghorn calculus and polycystic kidney in the coronal plane; Below the three-dimension reconstructed CT image of calculus and kidney.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3733947&req=5

Figure 1: CT images of a complete staghorn calculus in the right kidney in an ADPKD female. Above the staghorn calculus and polycystic kidney in the coronal plane; Below the three-dimension reconstructed CT image of calculus and kidney.
Mentions: One week before admission, this patient’s urinary irritation relapsed with high fever. As oral antibiotics were not responsive, she was admitted in this hospital for further treatment. On admission, her temperature was 39.0°C, blood pressure 110/82 mmHg. Physical examination revealed the bilateral enlarged kidneys that were palpable, tenderness existed in right flank area. Full blood cell count showed white blood cell count 11.1 × 109/l, hemoglobin 12.3 g/dl and platelets 157 × 109/l. A serum biochemical profile showed her renal function was normal with serum creatinine 0.74 mg/dl. Liver function and electrolytes were unremarkable. Urinalysis revealed +3 leukocytes, +2 blood, and +1 albumin. Chest radiology and electrocardiography were reported to be normal. Abdominal CT scan showed enlarged cystic kidneys and a complete staghorn calculus in the right kidney with no obvious signs of urinary tract obstruction (Figure 1). Wide spectrum antibiotics was administered intravenously and the symptoms relieved in 3 days.

Bottom Line: Kidney stones in patients with autosomal dominant polycystic kidney disease are common, regarded as the consequence of the combination of anatomic abnormality and metabolic risk factors.We report a case of complete staghorm calculus in a polycystic kidney disease patient induced by repeatedly urinary tract infections.This 37-year-old autosomal dominant polycystic kidney disease female with positive family history was admitted in this hospital for repeatedly upper urinary tract infection for 3 years.

View Article: PubMed Central - HTML - PubMed

Affiliation: Kidney Institute of CPLA, Division of Nephrology, Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai 200003, China. maozhiguo93@gmail.com

ABSTRACT

Background: Kidney stones in patients with autosomal dominant polycystic kidney disease are common, regarded as the consequence of the combination of anatomic abnormality and metabolic risk factors. However, complete staghorn calculus is rare in polycystic kidney disease and predicts a gloomy prognosis of kidney. For general population, recent data showed metabolic factors were the dominant causes for staghorn calculus, but for polycystic kidney disease patients, the cause for staghorn calculus remained elusive.

Case presentation: We report a case of complete staghorm calculus in a polycystic kidney disease patient induced by repeatedly urinary tract infections. This 37-year-old autosomal dominant polycystic kidney disease female with positive family history was admitted in this hospital for repeatedly upper urinary tract infection for 3 years. CT scan revealed the existence of a complete staghorn calculus in her right kidney, while there was no kidney stone 3 years before, and the urinary stone component analysis showed the composition of calculus was magnesium ammonium phosphate.

Conclusion: UTI is an important complication for polycystic kidney disease and will facilitate the formation of staghorn calculi. As staghorn calculi are associated with kidney fibrosis and high long-term renal deterioration rate, prompt control of urinary tract infection in polycystic kidney disease patient will be beneficial in preventing staghorn calculus formation.

Show MeSH
Related in: MedlinePlus