Medullary Sponge Kidney: Clinical and Radiological Manifestations

The paper describes a case of medullary sponge kidney with gross hematuria in a 69-year old woman. The case is of interest due to the rarity of the disease and the difficulty of recognition for both the radiologist (the results of computed tomography are non – specific), and for the attending physician (due to the poor clinical finding). Medullary sponge kidney is a benign congenital abnormality characterized by the formation of diffuse, bilateral medullary cysts caused by abnormalities in pericalyceal terminal collecting duct. The etiology is unknown, but in approximately 5 % of cases there is a genetic predisposition, according to the autosomal dominant type of inheritance. Literature review and a case study of medullary sponge kidney are presented. CT urography is one of the methods of choice in this pathology, and its value is especially great in recognizing the causes of complications of the disease, such as nephrolithiasis and macrohematuria. Purpose: to increase the awareness of practicing radiologists about CT signs of medullary spongy kidney. Material and methods: the data from the literature, as well as our own observation of the developmental abnormality – medullary spongy kidney – are presented. Results: CT scan capabilities in the diagnosis of medullary spongy kidney are described. Conclusion: CT is not the only, but an important method of diagnosis of medullary spongy kidney and knowledge of its pathophysiology and radiological manifestations will allow to make a correct diagnosis in time and prescribe the appropriate treatment.