![]() ![]() In a retrospective analysis with 52 kidneys with complete staghorn calculi, 56% of the kidney stones were metabolic and 44% were infection stones. However, recent data challenged this traditional opinion. In general population, staghorn calculi were traditionally believed to be synonymous with infection stone, and secondary to of UTI. There are no generally accepted causes for the formation of staghorn calculi in ADPKD. Hypocitruria, aciduria and low urinary magnesium are common metabolic defects in ADPKD, and these factors facillate the formation and aggregation urinary crystal. Numerous expanding kidney cysts distort the intrarenal calyceal system, which leads to urinary stasis and delayed washout of urinary crystals. Patients with a larger kidney volume predominant cyst size are at a higher risk of stone formation. In our center data, there is only one case with complete staghorn kidney calculus among 412 regularly followed ADPKD patients (221 male and 191 female) in the past twelve years.Ĭalcium oxalate and/or uric acid are the most components of kidney stone in ADPKD, although the percentage of metabolic disturbances was not higher in ADPKD patients with kidney calculus than without. The incidence of kidney calculus in ADPKD patients ranges from 8% to 36%, much higher than in general population, while ADPKD with staghorn calculus is rare. Wide spectrum antibiotics was administered intravenously and the symptoms relieved in 3 days. 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). Chest radiology and electrocardiography were reported to be normal. Urinalysis revealed +3 leukocytes, +2 blood, and +1 albumin. Liver function and electrolytes were unremarkable. A serum biochemical profile showed her renal function was normal with serum creatinine 0.74 mg/dl. Full blood cell count showed white blood cell count 11.1 × 10 9/l, hemoglobin 12.3 g/dl and platelets 157 × 10 9/l. Physical examination revealed the bilateral enlarged kidneys that were palpable, tenderness existed in right flank area. On admission, her temperature was 39.0☌, blood pressure 110/82 mmHg. As oral antibiotics were not responsive, she was admitted in this hospital for further treatment. One week before admission, this patient’s urinary irritation relapsed with high fever. Symptoms usually were relieved within a week with antibiotics therapy, but the infections relapsed easily. Since then, she suffered from urinary tract infection every 3–4 months, and urine cultures were negative. ADPKD was diagnosed considering her family history. After admission, bilateral enlarged kidneys full of fluid-filled cysts were detected by type-B ultrasound examination, and there were no calculus or crystals in the kidneys detected at that time. ![]() Three years ago, the patient was admitted in community hospital for urinary tract irritation with right flank pain and fever for 2 days, and right upper urinary tract infection was considered. 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.Ī 37-year-old ADPKD female patient with positive family history was admitted in this hospital for repeatedly urinary tract infection for 3 years. UTI is an important complication for polycystic kidney disease and will facilitate the formation of staghorn calculi. 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. 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. We report a case of complete staghorm calculus in a polycystic kidney disease patient induced by repeatedly urinary tract infections. 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. ![]() However, complete staghorn calculus is rare in polycystic kidney disease and predicts a gloomy prognosis of kidney. 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. ![]()
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