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多孔视角:髓质海绵肾的全面综述

Porous perspectives: a comprehensive review of medullary sponge kidney.

作者信息

Camolese Bárbara Almeida, Rainato Gustavo Santos, Garcia Isadora Soares Bicalho, Ribeiro de Almeida Naira Kelly, Galante Stella Cardoso, Batista Vitor Neves, Albuquerque Anna Luiza Braga, Vaz de Castro Pedro Alves Soares, Simões E Silva Ana Cristina

机构信息

Interdisciplinary Laboratory of Medical Investigation, Unit of Pediatric Nephrology, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil.

Department of Pediatrics, Faculty of Medicine, UFMG, Researcher Level 1A of CNPq, Alfredo Balena Avenue, 190, 2Nd Floor, Room # 281, Belo Horizonte, MG, 30130-100, Brazil.

出版信息

Int Urol Nephrol. 2025 Apr 26. doi: 10.1007/s11255-025-04531-0.

DOI:10.1007/s11255-025-04531-0
PMID:40287601
Abstract

BACKGROUND AND AIM

Medullary sponge kidney (MSK), a congenital abnormality characterized by dilated collecting ducts in the kidneys, presents with a variable clinical spectrum. This narrative review summarizes the current knowledge on MSK, encompassing its clinical presentation, pathogenesis, recent developments in imaging and laboratory techniques for diagnosis, and the growing understanding of its genetic basis.

RESULTS

Some individuals with MSK may be asymptomatic, others may experience hematuria, renal colic due to kidney stones, recurrent urinary tract infections, and metabolic imbalances. The precise cause of MSK remains unclear, but genetic factors are believed to play a role, with genetic variants identified in genes like GDNF (Glial cell line-derived neurotrophic factor), RET (Rearranged during transfection), and PKHD1 (Polycystic kidney and hepatic disease 1). The diagnosis is based on imaging findings and MSK has no specific treatment.

CONCLUSION

Further research is warranted to improve our understanding of MSK and develop targeted therapies.

摘要

背景与目的

髓质海绵肾(MSK)是一种先天性异常,其特征为肾脏集合管扩张,临床表现多样。本叙述性综述总结了目前关于MSK的知识,包括其临床表现、发病机制、诊断方面影像学和实验室技术的最新进展,以及对其遗传基础的日益深入的理解。

结果

一些患有MSK的个体可能无症状,另一些可能出现血尿、肾结石导致的肾绞痛、复发性尿路感染和代谢失衡。MSK的确切病因尚不清楚,但认为遗传因素起作用,在胶质细胞源性神经营养因子(GDNF)、转染重排(RET)和多囊肾和肝病1(PKHD1)等基因中已鉴定出遗传变异。诊断基于影像学检查结果,且MSK没有特异性治疗方法。

结论

有必要进一步开展研究,以增进我们对MSK的理解并开发靶向治疗方法。

相似文献

1
Porous perspectives: a comprehensive review of medullary sponge kidney.多孔视角:髓质海绵肾的全面综述
Int Urol Nephrol. 2025 Apr 26. doi: 10.1007/s11255-025-04531-0.
2
New non-renal congenital disorders associated with medullary sponge kidney (MSK) support the pathogenic role of GDNF and point to the diagnosis of MSK in recurrent stone formers.新的非肾脏先天性疾病与髓质海绵肾(MSK)相关,支持 GDNF 的致病作用,并指出在复发性结石形成者中 MSK 的诊断。
Urolithiasis. 2017 Aug;45(4):359-362. doi: 10.1007/s00240-016-0913-6. Epub 2016 Aug 29.
3
Identification of GDNF gene sequence variations in patients with medullary sponge kidney disease.鉴定多发性髓质海绵肾患者的 GDNF 基因序列变异。
Clin J Am Soc Nephrol. 2010 Jul;5(7):1205-10. doi: 10.2215/CJN.07551009. Epub 2010 May 6.
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Medullary Sponge Kidney: Current Perspectives.髓质海绵肾:当前观点
Int J Nephrol Renovasc Dis. 2019 Sep 26;12:213-218. doi: 10.2147/IJNRD.S169336. eCollection 2019.
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Heterozygous Pkhd1 mice develop cystic liver disease and proximal tubule ectasia that mimics radiographic signs of medullary sponge kidney.杂合性 Pkhd1 小鼠会发展出囊性肝病和近端小管扩张,这些病变模拟了海绵肾的放射影像学特征。
Am J Physiol Renal Physiol. 2019 Mar 1;316(3):F463-F472. doi: 10.1152/ajprenal.00181.2018. Epub 2019 Jan 2.
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Association of medullary sponge kidney and hyperparathyroidism with RET G691S/S904S polymorphism: a case report.髓质海绵肾及甲状旁腺功能亢进与RET基因G691S/S904S多态性的关联:一例报告
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Medullary sponge kidney: state of the art.髓质海绵肾:最新进展。
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The impact of modern endourological techniques in the treatment of a century old disease--medullary sponge kidney with associated nephrolithiasis.现代腔内泌尿外科技术对一种百年老病——髓质海绵肾合并肾结石治疗的影响。
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[Kidney sponge--treatment--case report].[肾海绵肾——治疗——病例报告]
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本文引用的文献

1
Diagnosis and treatment of bilateral adrenal pheochromocytoma with RET gene mutation combined with medullary sponge kidney: A case report.双侧肾上腺嗜铬细胞瘤伴 RET 基因突变合并髓质海绵肾的诊治:病例报告。
Medicine (Baltimore). 2023 Jun 9;102(23):e34022. doi: 10.1097/MD.0000000000034022.
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Single-Cell Gene Expression Analysis in Patients with Medullary Sponge Kidney and a Retrospective Study.多囊性肾髓质患者的单细胞基因表达分析及回顾性研究。
Biomed Res Int. 2022 Nov 11;2022:7688947. doi: 10.1155/2022/7688947. eCollection 2022.
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Proteomics Insights into Medullary Sponge Kidney Disease: Review of the Recent Results of an Italian Research Collaborative Network.
髓质海绵肾疾病的蛋白质组学见解:意大利研究协作网络近期成果综述
Kidney Blood Press Res. 2022;47(12):683-692. doi: 10.1159/000527195. Epub 2022 Oct 20.
4
Hypokalemic Periodic Paralysis Secondary to Medullary Sponge Kidney Complicated With Renal Tubular Acidosis.继发于髓质海绵肾并合并肾小管酸中毒的低钾性周期性麻痹
Cureus. 2022 Oct 10;14(10):e30160. doi: 10.7759/cureus.30160. eCollection 2022 Oct.
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Atypical Clinical Presentation of Autosomal Recessive Polycystic Kidney Mimicking Medullary Sponge Kidney Disease.常染色体隐性多囊肾模仿髓质海绵肾疾病的非典型临床表现。
Kidney Int Rep. 2021 Dec 6;7(4):916-919. doi: 10.1016/j.ekir.2021.11.035. eCollection 2022 Apr.
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Sphingomyelin and Medullary Sponge Kidney Disease: A Biological Link Identified by Omics Approach.鞘磷脂与髓质海绵肾疾病:通过组学方法确定的生物学联系
Front Med (Lausanne). 2021 May 26;8:671798. doi: 10.3389/fmed.2021.671798. eCollection 2021.
7
Variable Expressivity of HNF1B Nephropathy, From Renal Cysts and Diabetes to Medullary Sponge Kidney Through Tubulo-interstitial Kidney Disease.HNF1B肾病的可变表达性,从肾囊肿和糖尿病到通过肾小管间质性肾病发展为髓质海绵肾。
Kidney Int Rep. 2020 Oct 7;5(12):2341-2350. doi: 10.1016/j.ekir.2020.09.042. eCollection 2020 Dec.
8
Ultrasound to address medullary sponge kidney: a retrospective study.超声处理髓质海绵肾:一项回顾性研究。
BMC Nephrol. 2020 Oct 12;21(1):430. doi: 10.1186/s12882-020-02084-1.
9
Nephrocalcinosis: A Review of Monogenic Causes and Insights They Provide into This Heterogeneous Condition.肾钙质沉着症:单基因病因的综述及其对这种异质性疾病的深入了解。
Int J Mol Sci. 2020 Jan 6;21(1):369. doi: 10.3390/ijms21010369.
10
Proteomic Analysis of Urinary Extracellular Vesicles Reveals a Role for the Complement System in Medullary Sponge Kidney Disease.尿细胞外囊泡的蛋白质组学分析揭示补体系统在髓质海绵肾疾病中的作用。
Int J Mol Sci. 2019 Nov 5;20(21):5517. doi: 10.3390/ijms20215517.