TY - JOUR
T1 - Chronic pain in medullary sponge kidney: a rare and never described clinical presentation
AU - Gambaro, Giovanni
AU - Goldfarb, D. S.
AU - Baccaro, Rocco
AU - Hirsch, J.
AU - Topilow, N.
AU - D'Alonzo, Silvia
AU - Gambassi, Giovanni
AU - Ferraro, Pietro Manuel
PY - 2018
Y1 - 2018
N2 - Medullary sponge kidney (MSK) is a cause of nephrocalcinosis, associated with hematuria, renal colic, pyelonephritis. There are rare and atypical MSK cases characterized by chronic severe pain (CP), whose features are unknown, in particular the relationship with the stone disease activity. This study analyzes a cohort of MSKâCP patients belonging to three North-America self-support Facebook groups. Patients had to self-administer an on-line questionnaire (on intensity, progression and MSK-associated conditions, stone-related disease, pain features, drug use), the Brief Pain Inventory, the Fatigue Severity Score, and Wisconsin Quality of Life (WQL) in stone formers questionnaires. Ninety-two patients with a diagnosis of MSK joined our survey. Stone rate was very high (3.1 stones per patient-year, < 15% of patients had ⤠1 stone per year). Most patients had repeated hospitalizations for stones symptoms (p < 0.001) or pain (p < 0.005). 71% of participants referred a daily pain that interfered strongly with everyday life and quality of life (WQL mean value 29.4). 69% used pain medications daily (70% opioids). In most cases, pain was associated with stone passage, while 15% referred a sine materia pain. We showed how MSKâCP symptoms affect very negatively on the quality of life of these patients. They also have a definite risk of progressing to end-stage kidney disease. Generally, CP seems to be associated with an exceptionally high lithogenic activity, suggesting that a better and earlier metabolic treatment for stone prevention should be the first approach in these patients before mini-invasive treatments to prevent pain.
AB - Medullary sponge kidney (MSK) is a cause of nephrocalcinosis, associated with hematuria, renal colic, pyelonephritis. There are rare and atypical MSK cases characterized by chronic severe pain (CP), whose features are unknown, in particular the relationship with the stone disease activity. This study analyzes a cohort of MSKâCP patients belonging to three North-America self-support Facebook groups. Patients had to self-administer an on-line questionnaire (on intensity, progression and MSK-associated conditions, stone-related disease, pain features, drug use), the Brief Pain Inventory, the Fatigue Severity Score, and Wisconsin Quality of Life (WQL) in stone formers questionnaires. Ninety-two patients with a diagnosis of MSK joined our survey. Stone rate was very high (3.1 stones per patient-year, < 15% of patients had ⤠1 stone per year). Most patients had repeated hospitalizations for stones symptoms (p < 0.001) or pain (p < 0.005). 71% of participants referred a daily pain that interfered strongly with everyday life and quality of life (WQL mean value 29.4). 69% used pain medications daily (70% opioids). In most cases, pain was associated with stone passage, while 15% referred a sine materia pain. We showed how MSKâCP symptoms affect very negatively on the quality of life of these patients. They also have a definite risk of progressing to end-stage kidney disease. Generally, CP seems to be associated with an exceptionally high lithogenic activity, suggesting that a better and earlier metabolic treatment for stone prevention should be the first approach in these patients before mini-invasive treatments to prevent pain.
KW - Medullary sponge kidney
KW - Nephrolitiasis
KW - Nephrology
KW - Pain
KW - Renal colic
KW - Renal stones
KW - Medullary sponge kidney
KW - Nephrolitiasis
KW - Nephrology
KW - Pain
KW - Renal colic
KW - Renal stones
UR - http://hdl.handle.net/10807/113782
UR - http://www.springer.com/medicine/nephrology/journal/40620
U2 - 10.1007/s40620-018-0480-8
DO - 10.1007/s40620-018-0480-8
M3 - Article
SN - 1121-8428
VL - 31
SP - 537
EP - 542
JO - JN. JOURNAL OF NEPHROLOGY
JF - JN. JOURNAL OF NEPHROLOGY
ER -