Follow-Up Of Hospitalized Infants With Urinary Stone Induced By Melamine-Related Milk After Two Years

Objective To investigate hospitalized infants and children with urinary calculi (MUS)induced by melamine contamination milk the clinical characteristics in 2008 and immediate impact on form and function of kidney and bladder and on the growth and development of infants after two years.Methods 186 cases of children were Selected and diagnosed with urinary calculi caused by melamine tainted milk powder in First Affiliated Hospital of Zhengzhou University from August to November,2008, following-up by letter, telephone and outpatient after 2 years. Follow-up including tests of blood, urine, renal function, urinary tract ultrasound, disease outcome, growth and development, recording children's weight, height, the clinical symptoms and complications of acute renal failure and urinary tract tumors. Selecting 150 cases of normal children as controls (CG) fed non-exclusive breastfeeding with no melamine contaminated milk powder in the same period. Analysising clinical data of 186 hospitalized patients and comparing the relevant parameters with the control group. Results 169 cases of children followed up successfully, and 92 cases of children with stones were treated conservatively outside the hospital, the stone of 76 patients disappeared when follow-up, and 1 case increased, no significant changes in 4 cases,11 cases smaller. Output of urine and renal function of children with renal failure returned to normal level. Tests of children's blood, urine, form and function of kidney and bladder were normal. Follow-up found no incidence of urinary tract lesions. Threre was no significant difference (p> 0.05)in weight between patients and control group. The comparison showed the number of patients with low height increased significantly (p<0.05), and the number of infants with calcium in CG was greatly higher than in MUS.41 cases of female children, male 145 cases, at the age of 2-52 months in hospital, mean (13.8±9.2) months, the age (30.4±10.2) months of follow-up.The average hospital staying (10±4) days, all clinical symptoms disappeared, no significant changes in 23 patients,69 patients with smaller stones, stones of 94 cases disappeared completely.The degree of hydronephrosis in 34 cases reduced. Hydronephrosis in 36 cases disappeared and did not change significantly in 5 patients, with no patients died. Urinary Stones Melamine based mainly in kidney, and there were separations of 91 sides of the renal pelvis collecting system in 68 cases. Mostly Urinary Stones Melamines were sediment and often multiple, and ultrasound has the characteristic performance. pH of urinary in patients was significantly lower than the control group before treatment and BUN, Scr, SUA in the control group, moderate group and mild group were greatly lower than in severe group.169 cases of MUS children with successful follow-up, including 92 cases of children with a stone.Stones in 88 patients followed up disappeared without surgical intervention, and stones in 82 cases were resolved within six months, and stones in 3 patients tured into opaque stones,1 case of kidney stones increased, and the stone discovery of new generation of unilateral kidney in 1 case.34 cases of hydronephrosis disappeared, of which 24 cases occurred within six months, and 4 reduced, no significant change in 1 case. Urinary tract tumor no found, tests of urine, blood and kidney function showed no obvious abnormalities. The number of patients with low height increased significantly (p<0.05), but body weight compared with the control group, no significant difference (p> 0.05). Conclusions Feeding of infants and children with melamine contaminated milk can lead to urinary calculi, the peak age of onset in 2 years, the disease found often after 6 to 12 months, kidney stones more common,mostly stones muddy and usually multiple. Clinical symptoms are often not obvious, and a conservative non-surgical medical treatment was very good. Melamine melamine and uric acid are the main ingredients of stones.Through conservative treatment, stones can be discharged in about six months,and hydronephrosis can disappear. However, some melamine stones can be turned into X-opaque stones. After 2 years follow-up, we found no abnormal changes of structure and function in urinary tract and tumor and significant adverse effects on growth and development of children because of melamine contaminated milk powder.