Pediatric Medullary Sponge Kidney Treatment & Management

Updated: Aug 28, 2021
  • Author: Howard Trachtman, MD; Chief Editor: Craig B Langman, MD  more...
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Treatment

Medical and Surgical Care

Medical care

No specific treatment for medullary sponge kidney (MSK) is warranted. In a retrospective study of 97 adults with medullary sponge kidney, administration of oral potassium citrate to patients with at least one risk factor (hypercalciuria, hyperuricosuria, hyperoxaluria, hypocitraturia) resulted in a dramatic reduction in kidney stone stones (from 0.58 to 0.10 stones/patient/y). [12]  Although these findings require confirmation in a prospective trial, the therapy is safe and inexpensive.

If hypercalciuria-associated kidney stone disease is present, use of thiazide diuretics or other measures to reduce the hypercalciuria may be justified. [13]  Renal stones are managed in the same way as in individuals without medullary sponge kidney. [14]  Treat urinary tract infections (UTIs) with standard courses of antibiotics. Prophylactic antibiotics may help patients with medullary sponge kidney and recurrent UTIs. In patients with hemihypertrophy, serial screening should be performed to exclude a malignancy.

Surgical care

Surgery is not needed for most patients with medullary sponge kidney.

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Diet and Activity

Diet

Although decreased dietary calcium intake may decrease urinary calcium excretion, concern has been expressed that it might also result in skeletal undermineralization. Decreased sodium intake and increased potassium intake may improve urinary calcium excretion by themselves and are recommended in patients taking thiazide diuretics.

Activity

Because medullary sponge kidney is a nonprogressive condition with small medullary cysts, restriction of physical activity is unnecessary.

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