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• Organic base
• Trimer of cyanide
• Typically formed from
the dehydration of urea 3rd1000.com
• In industry is combined
with formaldehyde to
form a heat resistant,
scratch resistant plastic
tutorvista.com
Current Uses of Melamine
AND . . .
marlerblog.com
professorshouse.com
Why melamine?
• Melamine is composed
of 66% nitrogen
• Can be added to
products to falsely
increase the protein
content
Chinese Melamine Scandal
• September 11, 2008 Sanlu, the largest
milk producer in China, recalled 10,000
tons of infant formula tainted with
melamine
• 21 other companies found to have
contaminated milk
• Speculated that companies first
reported contamination in early July
1. Garcia Lopez FJ, Quereda C. Melamine toxicity: one more culprit in calcium
kidney lithiasis. Kidney Int 2011;80:694-6.
Sanlu Milk Powder and Upper
Limits
Sanlu’s milk powder contained:
• 2.56 g/kg of melamine
1. Qiu L, Binns CW, Zhao Y, Lee AH, Xie X. Breastfeeding practice in Zhejiang
province, PR China, in the context of melamine-contaminated for mula milk. J
Health Popul Nut r 2010;28:189-98.
Chinese Melamine Scandal
• ~300,000 infants and children were ill
• ~ 52,000 infants and children were
hospitalized
• 6 children died
Symptoms of melamine
toxicity in children
• Restlessness • Acute kidney injury*
• Diarrhea • Oliguria
• Hematuria • Anuria
• Hx of stone • Edema
passage*
• Renal Colic*
NO SYMPTOMS AT ALL!
Hau AK, Kwan TH, Li PK. Melamine toxicity and the kidney. J Am Soc Nephrol
2009;20:245-50.
Shang P, Chang H, Yue ZJ, et al. Acute kidney injury caused by consumption
of melamine-contaminated infant formula in 47 children: a multi-
institutional experience in diagnosis, treatment and follow-up. Urol
Res 2011;
Variable Conservative Intervention Group
Group
Gender
Male 303 (66) 105(65.6)
Female 156 (33) 55 (34.4)
Medical History
Stone Passage 19 (4.1) 10 (6.3)
No present ing symptoms 422 (91.9) 98 (61.3)
Calculi location
Bilateral kidney 159 (34.6) 55 (34.4)
Bilateral ure ter 19 (4.1) 42 (26.3)
Bladder 7 (1.5) 20 (12.5)
Sun et al 2009
• 25 children with urinary tract caliculi and
acute renal failure
• Ages 6-36 months
• Mean exposure of 9.5 months
Results
Results
• Renal functions impaired in all patients
• 44% of patients needed cystoscopy and
catherization
• 28% were dialysed
• 28% received fluids for 4-20 days
• At follow up at 3 months, 68% were
found to be free from stones
Conclusion
• Melamine tainted formula can cause
calculi
• Stones found in infants contain uric acid
and melamine rather than cyanuric acid
• All types of treatment were successful
Mechanism of Action
• Melamine is alkalescent
• When introduced to acid can form
cyanuric acid
www.sciencemadness.org/talk/files.php?pid=185660&aid=11296
Sun et al
• Cyanuric acid can decrease the body
fluid pH
• If pH is less than 5.5, uric acid can
accumulate leading to formation of
crystals
• Crystals block urine flow and increased
renal pressure AKI
Sun et al
Concluded that:
• It is an obstruction of the renal tubules,
rather than a toxicity to the kidney itself,
that causes renal damage
We have clearly identified the short-term
impacts of this disaster, but what about
long-term?
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