Direct renal chemolysis with alkaline drug for infantile renal calculus resulted from melamine / 中华泌尿外科杂志

ABSTRACT

Objective To evaluate the efficacy and safety of direct renal chemolysis with alkaline drug through ureteral catheter or nephrostomy tube for the treatment of infantile renal calculus resul-ted from melamine. Methods Fifteen infants of acute post-renal failure resulted from bilateral renal calculi were treated. The age of the infants was 5--12 months(average, 9 months). Stone size varied from 0.4 to 1.5 cm (average, 0.8 cm). They were all fed on milk powder polluted with melamine for a long time and diagnosed with acute post-renal failure based on the imaging and chemical examination. Double-J stents insertion by ureteroscope was performed on 13 infants and direct renal chemolysis with alkaline drng(5% NaHCO3,20 ml)through ureteral catheter was performed during operation. Percuta-neous nephrostomy was performed on 2 infants to remove the obstruction of upper urinary tract and di-rect renal chemolysis with alkaline drug(1.4% NaHCO3, continuous perfusion by gravity) through ne-phrostomy tube was performed intermittently after operation. Results Direct renal chemolysis was performed successfully on the 15 infants. The urine volume recovered in 2--5 d, blood urea nitrogen and serum creatinine recovered in 2--3 d postoperatively. During the operation of the infants treated by direct renal chemolysis with 5%NaHCO3 throuth ureteral catheter, a large number of limous fluid spurted from ureterostoma. According to CT examination 2 weeks after operation, the stone frag-ments were removed thoroughly in 13 infants, the diameter of the stone lessened more than 50% in 2 infants. Conclusion Direct renal chemolysis with alkaline drug for eliminating infantile renal cal-culus resulted from melamine is sale and effective.