International Journal of Clinical & Medical Images

A 50 year-old male patient was diagnosed as having Cacchi-Ricci following episodes of recurrent renal colic since childhood. His renal function was normal and intravenous urography showed bilateral renal ectasy and calcification of renal tubules with multiple radiopaque images located in all caliceal groups, predominantly in the right kidney, without obstructive uropathy (Figure 1). Laboratory studies showed the presence of hypocitraturia with other urinary parameteres showing normal values. Abdominal computed tomography scan showed multiple renal calculi (from 3 to 7 mm) in both kidneys, which had a regular and normal size (Figure 2). In over 90% of cases, computations were made calcium excreted oxalate. After starting treatment with potassium citrate, renal colic episodes were significantly reduced.

The Cacchi - Ricci disease or “medullary sponge kidney” is an uncommon disease (1:5000 to 1:20000) predominantly affecting young women. It is characterized by a malformation of the distal collecting tubules in the pericalycial pyramids. It is a condition usually asymptomatic that may present hematuria (gross or microscopic), the urinary tract infections and recurrent kidney stones, the most common clinical manifestations (15-20%).

*Corresponding author: Pimentel VD, Nephrology Service, University Hospital Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain; Tel: 34-922602921, E-Mail: vdpimentel.ull@hotmail.com