World Journal of Urology

, Volume 28, Issue 5, pp 603–607 | Cite as

The clinical analysis of young children’s urolithiasis due to melamine-tainted infant formula

  • Da-Qing Sun
  • Xu-Feng Zhang
  • Lei Zhang
  • Hao Feng
  • Yu-Hai Yang
Original Article



To analyze etiology, clinical features, effective diagnostic methods and therapeutic efficacy of infant urolithiasis related to melamine.


A total of 2,235 children fed with milk products were screened at the Second Hospital of Shandong University between 1st September and 31st December 2008. Of the children screened, 1,242 were male and 993 female, with a median age of 15 months (range 4–72 months). Among them, 182 with detailed data were enrolled and divided into Group 1 (calculus group, n = 79) and Group 2 (noncalculus group, n = 103) according to their results of the screening. All cases were reviewed with regard to melamine exposure, presentation, laboratory data, B-ultrasound findings and treatment efficacy.


Compared to 103 patients without stones, the 79 patients with stones confirmed by B-ultrasound had significant differences in: melamine daily intake (5.17 ± 4.53 vs. 2.38 ± 3.39 mg/kg per day, P < 0.001) and duration of problematic milk feeding (12.53 ± 8.47 vs. 8.65 ± 3.40 months, P < 0.001). Most of the patients in Group 1 (65.82%) were asymptomatic. In Group 1, all the patients with kidney stones less than 10 mm (n = 75) were successively treated conservatively, whereas the other four with kidney stones >10 mm required surgical treatment.


Melamine overdose can cause an increased risk of developing kidney stones in children. B-ultrasound is the first choice for the diagnosis of urolithiasis related to melamine. For most patients, the conservative treatment is effective; however, the patients with kidney stones >10 mm, surgery may be needed.


Infant Melamine Paediatrics Ultrasound Urolithiasis 



This project was funded by by Shandong Province Natural Science Foundation # Y2008C69.

Conflict of interest statement

There is no conflict of interest.


  1. 1.
    Rizvi SAH, Naqvi SA, Hussain Z et al (2002) Pediatric urolithiasis: developing nations perspectives. J Urol 168:1522–1525CrossRefPubMedGoogle Scholar
  2. 2.
    Chen JS (2009) A worldwide food safety concern in 2008—melamine-contaminated infant formula in China caused urinary tract stone in 290,000 children in China. Chin Med J 122(3):243–244PubMedGoogle Scholar
  3. 3.
    Parry J (2008) China’s tainted milk scandal spreads around world. BMJ 337:a1890CrossRefPubMedGoogle Scholar
  4. 4.
    WHO expert meeting to review toxicological aspects of melamine and cyanuric acid, Ottawa, Canada, 1–4 December 2008, Executive Summary. World Health Organization (2008) Available via DIALOG. Accessed 8 December 2008
  5. 5.
    The list of names of melamine contaminated milk products. General administration of quality supervision, inspection and quarantine of P.R.C. (2009) Available via DIALOG. Accessed 17 September 2008
  6. 6.
    Shen Y, Sun N, Jiang YP (2008) Explanation on “the treatment of the urinary calculus of the infant fed with melamine polluted formula milk”. Zhonghua Er Ke Za Zhi 46:816–819PubMedGoogle Scholar
  7. 7.
    Experts set tolerable level for melamine intake. In: News releases 2008. World Health Organization (2008) Available via DIALOG. Accessed 23 December 2008
  8. 8.
    La Manna A, Polito C, Cioce F et al (1998) Calyceal microlithiasis in children: report on 196 cases. Pediatr Nephrol 12:214–217CrossRefPubMedGoogle Scholar
  9. 9.
    Melamine and cyanuric acid: toxicity, preliminary risk assessment and guidance on levels in food 25 September 2008. Updated 30 October. US Food and Drug Administration (2008) Available via DIALOG. Accessed 23 December 2008
  10. 10.
    Pet food recall (melamine)/tainted animal feed. US Food and Drug Administration (2008) Available via DIALOG. Accessed 6 February 2008
  11. 11.
    Thompson ME, Lewin-Smith MR, Kalasinsky VF et al (2008) Characterization of melamine-containing and calcium oxalate crystals in three dogs with suspected pet food-induced nephrotoxicosis. Vet Pathol 45(3):417–426CrossRefPubMedGoogle Scholar
  12. 12.
    Guan N, Fan Q, Ding J et al (2009) Melamine-contaminated powdered formula and urolithiasis in young children. N Engl J Med. doi:10.1056/NEJMoa0809550
  13. 13.
    Lam CW, Lan L, Che X et al (2009) Diagnosis and spectrum of melamine-related renal disease: plausible mechanism of stone formation in humans. Clin Chim Acta 402(1–2):150–155. doi:10.1016/j.cca.2008.12.035 CrossRefPubMedGoogle Scholar
  14. 14.
    Brown CA, Jeong KS, Poppenga RH et al (2007) Outbreaks of renal failure associated with melamine and cyanuric acid in dogs and cats in 2004 and 2007. J Vet Diagn Invest 19(5):525–531PubMedGoogle Scholar
  15. 15.
    Puschner B, Poppenga RH, Lowenstine LJ et al (2007) Assessment of melamine and cyanuric acid toxicity in cats. J Vet Diagn Invest 19(6):616–624PubMedGoogle Scholar
  16. 16.
    Xin H, Stone R (2008) Tainted milk scandal. Chinese probe unmasks high-tech adulteration with melamine. Science 322:1310–1311CrossRefPubMedGoogle Scholar
  17. 17.
    Sun N, Shen Y, Sun Q et al (2008) Melamine related urinary calculus and acute renal failure in infants. Zhonghua Er Ke Za Zhi 46:810–815PubMedGoogle Scholar
  18. 18.
    Grases F, Costa-Bauzá A, Gomila I et al (2009) Melamine urinary bladder stone. Urology 73:1262–1263CrossRefPubMedGoogle Scholar
  19. 19.
    Ashworth M, Hill SM (1988) Endemic bladder stones in Nepal. Arch Dis Child 63(12):1503–1505CrossRefPubMedGoogle Scholar
  20. 20.
    Rennie JM (1992) Fluid and electrolyte balance. In: Roberton NRC (ed) Textbook of neonatology. Churchill Livingstone, Edinburgh, pp 233–250Google Scholar
  21. 21.
    Yi ZW (2003) Urinary diseases. In: Yang XQ (ed) Textbook of paediatrics. People’s Medical Publishing House, Beijing, pp 359–360Google Scholar
  22. 22.
    Hull JD, Kumar S, Pletka P (1980) Reflex anuria from unilateral ureteral obstruction. J Urol 123:265–266PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Da-Qing Sun
    • 1
  • Xu-Feng Zhang
    • 2
  • Lei Zhang
    • 3
  • Hao Feng
    • 4
  • Yu-Hai Yang
    • 1
  1. 1.Department of Vascular SurgerySecond Hospital of Shandong UniversityJinanChina
  2. 2.School of MedicineShandong UniversityJinanChina
  3. 3.Department of Pediatric SurgeryQilu Hospital of Shandong UniversityJinanChina
  4. 4.Department of AnaesthesiaSecond Hospital of Shandong UniversityJinanChina

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