In recent times, infants and children in some areas of China have consumed contaminated Sanlu brand infant formula, resulting in urinary stones. In order to do a good job in the diagnosis and treatment of children, the Ministry of Health in conjunction with the Chinese Medical Association organized experts to develop a “treatment plan for urinary stones in infants and young children associated with the consumption of contaminated Sanlu brand infant formula”. For clinical reference. Clinical manifestations (a) unexplained crying, especially during urination, may be accompanied by vomiting; (b) visual or microscopic hematuria; (c) acute obstructive renal failure, manifested as oliguria or anuria; (d) stones can be discharged in the urine, such as male infants stone obstruction of the urethra can be manifested as painful urination, difficulty in urination; (e) may have hypertension, edema, percussion pain in the kidney area. Diagnostic points (a) History of infant formula feeding with Sanlu brand. (B) One or more of the above clinical manifestations. (C) Laboratory tests: routine urine (visual or microscopic hematuria), blood biochemistry, liver and kidney function, urinary calcium/urinary creatinine (generally normal), urinary red blood cell morphology (non-glomerular-derived hematuria), parathyroid hormone measurement (generally normal). (iv) Imaging: Urological ultrasound is preferred. If necessary, CT scan of the abdomen and intravenous urography (contraindicated in the absence of urine or renal failure), and renal nuclide scan is feasible to evaluate the fractional renal function. Ultrasound features of urinary stones in infants and young children caused by the consumption of contaminated Sanlu infant formula: general features: enlargement of both kidneys; parenchymal echogenicity enhancement, parenchyma mostly of normal thickness; mild dilatation of renal pelvis and calyces, rounded and blunt renal calyces; if the obstruction is located in the ureteral lumen, the ureter is dilated above the point of obstruction; in some cases, perinephric fat pad and soft tissue edema around the ureter; with the development of the disease, the renal pelvic wall and In some cases, the perinephric fat pad and soft tissues around the ureter are edematous. The majority of stones involve the bilateral collecting system and bilateral ureters; ureteral stones are mostly located at the pelvic-ureteral junction, ureter across the iliac artery and ureteral-vesical junction; stones are crumb-like accumulation, involving a large area, with a faint posterior acoustic shadow, most of which are different from calcium oxalate stones, and the posterior edge of stones can be detected; urinary obstruction due to stones is more complete. Differential diagnosis (a) Differentiation of hematuria: pay attention to exclude glomerular-derived hematuria. (B) Differentiation of stones: stones are usually X-ray negative stones, which are not visible on urinary X-ray, and can be differentiated from positive stones such as calcium oxalate and phosphate, which are not X-ray positive. (C) Differentiation of acute renal failure, paying attention to the exclusion of prerenal and renal renal failure. Treatment (a) Immediately stop using Sanlu brand infant formula. (B) Conservative medical treatment: rehydration, alkalinization of urine to promote the discharge of stones; correction of water, electrolytes and acid-base balance disorders. During the course of conservative treatment, urine routine, blood biochemistry, renal function should be closely checked, and ultrasound should be repeated (especially pay attention to the degree of dilatation of renal pelvis and ureter and changes in stone shape and location). As the stones are loose or sand-like, they are more likely to be expelled on their own. (iii) Treatment of combined acute renal failure: Firstly, life-threatening conditions such as hyperkalemia should be corrected, such as the application of sodium bicarbonate and insulin, and if conditions are available, blood purification, peritoneal dialysis and other methods should be taken as early as possible, and if necessary, surgical intervention should be performed to relieve stone obstruction. (iv) Surgical treatment: If the stone morphology and location do not change by conservative medical treatment, and the hydronephrosis and renal damage are aggravated, or if renal failure does not allow hemodialysis or peritoneal dialysis, the obstruction can be removed surgically. Cystoscopic retrograde ureteral cannula drainage, percutaneous nephrostomy drainage, surgical excision and stone extraction, percutaneous nephrolithotomy, etc. are available. Because the stones are loose, uric acid is the main component, and the patient is an infant, extracorporeal shock wave lithotripsy has greater limitations and needs to be considered carefully. After the treatment, the stone obstruction is released, the general condition is improved, the kidney function is normalized, and the urine can be discharged. Follow-up after discharge: urinary routine; urological ultrasound; renal function test; intravenous pyelogram if necessary. Another article: Key points of education on urinary stones in infants and children associated with the consumption of contaminated Sanlu brand infant formula.