Medullary Sponge Kidney

Medullary sponge kidney is a benign congenital disorder characterized by dilatation of collecting tubules in 1 or more renal papillae, affecting 1 or both kidneys. Medullary sponge kidney is usually a benign condition, and patients can remain asymptomatic. The most important abnormality in medullary sponge kidney is the spherical, oval, or irregular dilatation of the medullary and papillary portions of the collective ducts.

The diagnosis of medullary sponge kidney is usually confirmed by findings on excretory urography , which reveals radial, linear striations in the papillae. These striations, which are often referred to as "brushlike" patterns, result from the collection of contrast in dilated and cystic collecting tubules. Cystic collections of contrast media in the ectatic collecting duct are referred to as "bunches of grapes" or "bouquets of flowers."

Points to Remember

  • Medullary sponge kidney (MSK) is a birth defect of the tubules inside the kidneys.
  • Problems caused by MSK include hematuria, kidney stones, and urinary tract infections (UTIs).
  • MSK symptoms do not usually appear until ages 30 to 40.
  • Most patients with MSK have no symptoms.
  • Diagnosis of MSK may require an intravenous pyelogram (IVP).
  • Treatment for MSK focuses on curing UTIs, removing kidney stones, and preventing recurrent infections and stones.

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