Medullary Sponge Kidney Treatment

Medullary sponge kidney (MSK) is a birth defect that can lead to kidney problems. MSK causes tiny cysts to form on the inside of the kidney in the medulla, creating problems with urine flow during its creation in the tiny tubes inside the kidneys. By blocking or restricting this urine flow, these cysts cause problems such as urinary tract or kidney infections, blood in the urine and stone formation inside the kidneys. MSK treatment involves resolving the complications of MSK. There is no way to remove the tiny cysts from the medulla of the kidney that result in MSK.

Acute Infection

• MSK cysts sometimes block urine from flowing properly from the tubules into the kidney. When the urine doesn't flow properly, it can cause bacteria to get trapped in the kidneys, leading to a urinary tract infection (UTI). In order to treat an acute UTI, doctors prescribe antibiotics to kill the bacteria. The type of antibiotic depends on the bacteria the doctor finds in a urine sample, and the bacteria levels determine the strength of the medication and how long the antibiotic treatment lasts.

Chronic Infection

• Sometimes the cysts from MSK cause chronic UTIs. The cysts can form in places that consistently block urine from passing correctly, so that antibiotic treatment works, but the bacteria immediately returns causing another infection. These chronic UTI's warrant the continuous use of antibiotics to keep bacteria from infecting the urinary tract. These antibiotics are usually low-dose.

Stone Removal

• If stones form in the kidneys and can't pass, other measures are available to break up the stone. Extracorporeal shock wave lithotripsy (ESWL) is the most common procedure to treat stuck stones. Shock waves break up the stone into tiny pieces, allowing it to pass in the urine. In percutaneous nephrolithotomy, a doctor makes a small cut in the back, inserts a nephroscope and removes the stone.

  If the stone is in the ureter, the doctor may perform ureteroscopic stone removal by inserting a uteroscope through the bladder to dislodge the stone. Calcium stones are sometimes the result of a tumor in the parathyroid gland, or problems with the gland itself. In these cases, a doctor may perform parathyroid surgery and remove the defective gland to prevent the high calcium it causes.

Stone Prevention

• When a person with MSK forms stones frequently, they may consider measures to prevent the stones from forming in the first place. Increased water intake and diet changes are the first line of treatment to prevent kidney stones from forming. Those prone to kidney stones need to drink a minimum of 14 glasses of water a day. Diets low in salt and animal protein also reduce the incidence of stones forming. Increased citrate prevents stone formation, so include citrus foods and drinks such as oranges and lemonade. For specific stones such as those high in oxylate, doctors recommend avoiding those chemicals to stop stone formation. For some, medication is the answer to stop stone formation. The type of medication depends on the chemical makeup of the stones in the kidneys.

Checkups

• Even if MSK is asymptomatic, or benign, many doctors recommend periodic checkups of the kidneys. These checkups include abdominal radiographs to evaluate structural abnormalities or increased cyst problems. Urinalysis is another periodic check necessary to evaluate for passage of high levels of minerals. Lowering mineral levels that are too high prevents kidney stones.

Warning

• MSK is normally a symptom-free medical condition. However, anyone with MSK that has any signs of kidney or urinary tract problems needs to see a doctor immediately. Urine stuck behind cysts for long periods can be life threatening or cause kidneys to stop functioning. While MSK rarely leads to kidney disease or permanent damages, it is possible. To prevent these serious complications, get regular checkups, treat any problems quickly and follow any directions doctors recommend.