How to treat kidney stones in patients with medullary sponge kidney

For relatively small stones, conservative treatment may be adopted. Maintaining adequate fluid intake with a daily urine output of more than 2000 mL, along with regular jumping exercises, can help expel small stones. Additionally, certain stone-expelling medications such as Nephrolithiasis Eliminator (Yushi Tong) may be used to facilitate stone passage. For larger stones, extracorporeal shock wave lithotripsy (ESWL) can be employed to break the stones into smaller fragments, which are then passed out through urine. In patients with sponge kidney, stones are often widely distributed and may require multiple treatments. For large stones or those causing impaired kidney function, percutaneous nephrolithotomy (PCNL) or flexible ureteroscopic lithotripsy may be considered. These procedures allow rapid stone removal and minimize damage to the renal pelvis. The specific treatment approach should be determined by clinicians based on individual patient conditions.