Department of Nephrology, Children's Hospital of Fudan University, Shanghai, 201102, China.
World J Pediatr. 2011 Aug;7(3):232-9. doi: 10.1007/s12519-011-0293-5. Epub 2011 Jun 1.
Melamine-contaminated milk powder was the cause of the 2008 outbreak of urolithiasis in young children and infants in China, but the prognosis of these children remains unknown. We hypothesized that urolithiasis induced by melamine-contaminated milk powder may be associated with secondary renal injury.
A total of 8335 children (≤6 years old) with a history of consuming melamine-contaminated milk powder were screened. Urine analysis and urinary system ultrasonography were performed. For children with urolithiasis, the basic information and the results of examination were recorded, and effective therapy was given. They were followed up for 6 months after the original diagnosis, and urinary microprotein profiles were measured.
Of the 8335 children, 105 (1.26%) were diagnosed with melamine-contaminated milk powder-associated urolithiasis. The size of the stone was correlated with the duration of exposure to melamine. Six months later, 69.8% (67) of the children with urolithiasis passed stones (follow-up rate: 91.4%). Of the 67 children, 28 passed stones within 2 months. The higher possibility of passing a stone was correlated with the smaller diameter of the stone (P<0.001). The detection rate of abnormal urinary microprotein excretion (microalbumin, immunoglobulin G, and N-acetyl-β-D-glucosidase) was 52.4% in children with persistent stones and 38.2% in those who passed their stones. The detection rate was lower in children who passed stones within 2 months (31.8%) than in those who passed stones in 2 to 6 months (50.0%). The levels of microalbumin/creatinine and immunoglobulin G/creatinine were significantly higher in children with persistent stones than in those who passed their stones.
Early passage of a stone may reduce the renal injury induced by melamine-contaminated milk powder-associated urolithiasis.
三聚氰胺污染奶粉是导致 2008 年中国婴幼儿尿路结石爆发的原因，但这些儿童的预后仍不清楚。我们假设三聚氰胺污染奶粉引起的尿路结石可能与继发肾损伤有关。
共筛选出 8335 名（≤6 岁）有食用三聚氰胺污染奶粉史的儿童。进行尿液分析和泌尿系统超声检查。对于尿路结石患儿，记录基本信息和检查结果，并给予有效治疗。在原诊断后随访 6 个月，测量尿微量蛋白谱。
8335 名儿童中，105 名（1.26%）诊断为三聚氰胺污染奶粉相关尿路结石。结石大小与三聚氰胺暴露时间有关。6 个月后，69.8%（67 名）尿路结石患儿结石排出（随访率：91.4%）。67 名患儿中，28 名在 2 个月内排出结石。结石排出可能性较高与结石直径较小有关（P<0.001）。持续结石患儿异常尿微量蛋白排泄（微量白蛋白、免疫球蛋白 G 和 N-乙酰-β-D-葡萄糖苷酶）的检出率为 52.4%，结石排出患儿为 38.2%。2 个月内排出结石的患儿（31.8%）检出率低于 2 至 6 个月排出结石的患儿（50.0%）。持续结石患儿微量白蛋白/肌酐和免疫球蛋白 G/肌酐水平明显高于结石排出患儿。
早期排石可能减轻三聚氰胺污染奶粉相关尿路结石引起的肾损伤。
