Author Affiliations: Department of Nephrology, Children's Hospital of Fudan University, Shanghai 201102, China (Gao J, Xu H, Kuang XY, Huang WY, Rao J, Qian QY, Cheng XY, Feng ZM, Xu J, Zhang X, Wang X); Department of Biostatistics and Social Medicines, School of Public Health, Fudan University, Shanghai 201102, China (Zhao NQ)

Corresponding Author: Hong Xu, MD, PhD, Department of Nephrology, Children's Hospital of Fudan University, Shanghai 201102, China (Tel: 86-21-64931006; Fax: 86-21-64931901; Email: hxu@shmu.edu.cn)

Background: Melamine-contaminated milk powder was the cause of the 2008 outbreak of urolithiasis in young children and infants in China, but the prognosis of these children remains unknown. We hypothesized that urolithiasis induced by melamine-contaminated milk powder may be associated with secondary renal injury.

Methods: A total of 8335 children (≤6 years old) with a history of consuming melamine-contaminated milk powder were screened. Urine analysis and urinary system ultrasonography were performed. For children with urolithiasis, the basic information and the results of examination were recorded, and effective therapy was given. They were followed up for 6 months after the original diagnosis, and urinary microprotein profiles were measured.

Results: Of the 8335 children, 105 (1.26%) were diagnosed with melamine-contaminated milk powder-associated urolithiasis. The size of the stone was correlated with the duration of exposure to melamine. Six months later, 69.8% (67) of the children with urolithiasis passed stones (follow-up rate: 91.4%). Of the 67 children, 28 passed stones within 2 months. The higher possibility of passing a stone was correlated with the smaller diameter of the stone (P<0.001). The detection rate of abnormal urinary microprotein excretion (microalbumin, immunoglobulin G, and N-acetyl-β-D-glucosidase) was 52.4% in children with persistent stones and 38.2% in those who passed their stones. The detection rate was lower in children who passed stones within 2 months (31.8%) than in those who passed stones in 2 to 6 months (50.0%). The levels of microalbumin/creatinine and immunoglobulin G/creatinine were significantly higher in children with persistent stones than in those who passed their stones.

Conclusions: Early passage of a stone may reduce the renal injury induced by melamine-contaminated milk powder-associated urolithiasis.

Key words: children; follow up; melamine; renal injury; urolithiasis     

World J Pediatr 2011;7(3):232-239