Nephrocalcinosis is a condition in which calcium levels in the kidneys increase as a cause of hyperparathyroidism.
It is now most commonly used to describe the calcification of renal parenchyma in radiology.
Nephrocalcinosis can be seen on radiographs and appears as fine granular mottling over the renal contours during its early stages.
These contours eventually form a dense mass, most commonly seen as an accidental finding of a medullary sponge kidney on an x-ray. However, it can cause terminal renal failure.
Stages of Nephrocalcinosis
- Microscopic Nephrocalcinosis
- Macroscopic Nephrocalcinosis
- Chemical Nephrocalcinosis
- Resistance to relative vasopressin with decreased renal concentration capacity and increased diuresis manifested as polyuria and polydipsia.
- Renal glycosuria, reduction of tubular glucose
- Reversible hypertension
- Kidney failure is usually reversible, but sometimes not.
The clinical features of microscopic Nephrocalcinosis (based on animal studies) may include the following:
- Decreased ability to concentrate
- The increase of urea nitrogen in the blood
- The prolongation of the transit time of nephrons in the distal tubule
- Acute pyelonephritis or urethral obstruction due to kidney stones
Clinical features of macroscopic Nephrocalcinosis (the most commonly encountered form) may include the following:
- Renal colic
- The approval of urinary stones
- Urinary tract infection
- La poliuria y polidipsia
- The proteinuria
- In Dent’s disease, loss of low molecular weight proteins, hypercalciuria, nephrolithiasis and
- microscopic pyuria
- Distal tubular dysfunction with a mild salt loss defect
- Proximal tubular dysfunction (unusual)
- Distal tubular acidosis Secondary
- Renal insufficiency
Common causes of Nephrocalcinosis
- Placental abruption
- Previous placenta
- Septic abortion
- Transfusion reactions
- Hypercalcemia and / or prolonged hypercalciuria
- Rejection of kidney transplant
- Sickle cell disease
- Vitamin B6 deficiency
- Severe dehydration
- Severe heart failure
- Abdominal aortic surgery
- Chronic glomerulonephritis
- Síndrome de Alport
- Medullary Nephrocalcinosis in ultrasound
- Medullary sponge kidney
- Acidosis tubular renal
- Tuberculosis renal
- Renal papillary necrosis
Treatment for Nephrocalcinosis
The treatment consists of the management of hypercalcemia and its cause. Proper hydration with isotonic sodium chloride solution, if necessary, is the most effective measure to protect the kidney.