Milk of calcium in the kidney

Milk of calcium of the kidneys is not synonymous with nephrocalcinosis, as management of these two entities differs. This important differential diagnosis must be considered in all patients with apparent large renal calculi on X-rays. We report a case of a 40-year old male who presented with acute kidney injury. An incidental finding of milk of calcium of the bilateral renal collecting system was also observed. Treatment is mostly conservative. However, those cases with obstructive nephropathy may need percutaneous endourological marsupialization or irrigation of the milk via flexible ureteroscope. In contrast to nephrolithiasis, the use of extracorporeal shock wave lithotripsy is unwarranted because it will only crack solid stones and not liquid material, as seen in milk of calcium.