Medullary sponge kidney

Patients with medullary sponge kidney (MSK) and nephrolithiasis should be followed up in the same way as patients with stones and no MSK. Metabolic abnormalities contributing to stone formation may be detected in the 24-hour urine stone risk profiles and may be modified by diet or medications.

Periodic monitoring with 24-hour urinary profiles should initially be more frequent if metabolic abnormalities are detected. Dietary and medication interventions should be followed by 24-hour urinary profiles 4 to 12 weeks after the intervention to determine whether metabolic abnormalities have improved. After stabilization of metabolic abnormalities, annual follow-up with a 24-hour urinary profile is advised.

In asymptomatic patients, annual radiologic follow-up is recommended to monitor stone formation. Patients with urinary tract infections and/or gross hematuria are usually symptomatic when they have recurrences and do not require scheduled follow-up. Ultrasound is usually preferred for screening purposes, although noncontrast computed tomography is more sensitive and specific.