Kidney Institute of CPLA, Division of Nephrology, Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai 200003, China.
BMC Nephrol. 2013 Aug 1;14:168. doi: 10.1186/1471-2369-14-168.
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. However, complete staghorn calculus is rare in polycystic kidney disease and predicts a gloomy prognosis of kidney. 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.
We report a case of complete staghorm calculus in a polycystic kidney disease patient induced by repeatedly urinary tract infections. 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. 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.
UTI is an important complication for polycystic kidney disease and will facilitate the formation of staghorn calculi. 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.
常染色体显性多囊肾病患者的肾结石很常见，被认为是解剖异常和代谢危险因素共同作用的结果。然而，多囊肾病中完全鹿角状结石很罕见，预示着肾脏预后不良。对于一般人群，最近的数据表明代谢因素是鹿角状结石的主要原因，但对于多囊肾病患者，鹿角状结石的病因仍不清楚。
我们报告了一例常染色体显性多囊肾病患者因反复尿路感染而导致的完全鹿角状结石。这名 37 岁女性患者有阳性家族史，患有常染色体显性多囊肾病，3 年来反复发生上尿路感染而入院。CT 扫描显示其右肾结石完全呈鹿角状，而 3 年前没有肾结石，结石成分分析显示结石的成分是镁铵磷酸盐。
尿路感染是多囊肾病的一个重要并发症，会促进鹿角状结石的形成。由于鹿角状结石与肾脏纤维化和长期肾功能恶化率高有关，因此及时控制多囊肾病患者的尿路感染有助于预防鹿角状结石的形成。
