Diagnosis, treatment and follow-up of 25 patients with melamine-induced kidney stones complicated by acute obstructive renal failure in Beijing Children's Hospital

Eur J Pediatr. 2010 Apr;169(4):483-9. doi: 10.1007/s00431-009-1093-y. Epub 2009 Oct 21.

Abstract

A total of 25 Chinese patients aged 6 to 36 months hospitalised at Beijing Children's Hospital due to melamine-induced kidney stones complicated by acute obstructive renal failure in 2008 were included in a study in order to diagnose and treat these special cases more effectively. Feeding history, clinical presentation, ultrasound findings, treatments and effects were summarised. Twelve to seventeen months follow-up was reported also. Ultrasound examination showed that calculi were located at the kidney and ureters. Stones were composed of both uric acid and melamine in a molar ratio of 1.2:1 to 2.1:1. Treatments providing liquid plus alkalisation of urine proved to be effective in helping the patients pass the stones. Surgical intervention was needed in severe cases. Renal function returned to normal in all 25 patients after various durations of therapy. Sixty-eight percent of the patients expelled all of the calculi within 3 months, 90% in 6 months and 95% in 9 months, without sequelae till now. Melamine-contaminated milk formula can cause kidney stones in infants, which should be diagnosed by feeding history, clinical symptoms and ultrasound examination. Composition of the stones was not only of melamine but also uric acid. Providing liquid orally or intravenously plus alkalisation of urine proved to promote the removal of the stones. Follow-up of 12 to 17 months after discharge showed no sequelae.

MeSH terms

  • Catchment Area, Health
  • Catheterization / methods*
  • Child, Preschool
  • China / epidemiology
  • Cystoscopy / methods*
  • Female
  • Follow-Up Studies
  • Food, Formulated / poisoning
  • Humans
  • Infant
  • Kidney Calculi* / chemically induced
  • Kidney Calculi* / epidemiology
  • Kidney Calculi* / therapy
  • Kidney Failure, Chronic* / chemically induced
  • Kidney Failure, Chronic* / epidemiology
  • Kidney Failure, Chronic* / therapy
  • Male
  • Renal Dialysis / methods*
  • Sodium Bicarbonate / therapeutic use*
  • Treatment Outcome
  • Triazines / adverse effects*

Substances

  • Triazines
  • Sodium Bicarbonate
  • melamine