| ObjectiveThe purposes of present study were1. To analyze the clinical features of the urolithiasis infants who were fed with melamine contaminated milk powder.2. To investigate the effect of acute renal failure due to melamine-related stone (MUS) on urinary and body development in infants by following up 2 years.Patients and MethodsPatientsA total of 290 infants and children who had the history of consumption melamine contaminated milk powder and got urinary stones from July to October in 2008 were involved in present study. The infants and children were divided into two kinds according to complicated with ARF or not. There were 269 infants (177 were male, and 92 were female, the ages during the hospital treatment were 16.0±10.2 months) who only had MUS. In addition,21 infants (11 were male,10 were female, were 10.5±5.7 months old during the hospital treatment) developed ARF due to MUS (ARF group). Two control groups were set simultaneously in this study. Thirty infants and children (20 males and 10 females, were 10.8±5.4 months old during the hospital treatment) with MUS but no ARF in our serial follow-up study were chosen as patient control group (MUS group). Fifty normal infants (32 males and 18 females, were 29.9±5.8 months old at the time of follow up) without the history of consuming melamine tainted milk powder were collected as health control group (health group). All groups were age & gender matched.Methods1. The clinical data of 290 infants and children was retrospectively analyzed. The information such as age, gender and feeding history of two kinds of patients were collected and compared.2. Two years follow-up was performed to the MUS group and ARF group through outpatient service, telephone or letter by professional doctors. Urinary ultrasonography, urinalysis and renal function tests were given to all the patients and the data of body weight and height, clinical signs, complications were collected. The relevant parameters of different groups were compared.Results1. The ages of the 21 ARF infants when admitted to hospital were smaller than the 269 MUS infants. And the incidence of bilateral renal or ureteral stones was significantly higher in the ARF infants than in the MUS-only infants. Nevertheless, the gender and the feeding history of the two kinds of infants have no significant difference.2. Seventeen infants and children suffered from ARF were successfully followed up. After treated by conservative management (12 of them were performed hemodialysis), all showed a good recovery since discharged from hospital 20 months ago. The results of urinalysis and renal function tests were normal. Ultrasonography show normal urinary morphology. Twelve of them shown residual stones either in the kidney or ureter at the time of discharge,7 disappeared completely,4 dissolved partially, and 1 did not change at the time of follow-up. Of the 8 infants with hydronephrosis at the time of discharge,1 did not change,2 decreased in size, and others recovered to normal. The parameters regarding to the kidney morphology and function did not show significant difference between different groups at the time of follow-up. The body weight and height between ARF group and MUS group did not show statistical significance.ConclusionThe younger and more severe the MUS, the easier of infants complicated with ARF. However, after conservative management including hemodialysis, the infants with ARF due to MUS have shown a good prognosis (ARF was corrected and symptoms disappeared). No effects on the body growth and development, and no urinary tumor were found at the time of 2 years follow up after discharging from hospital. |
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