nephrocalcinosis

Nephrocalcinosis: A Condition Characterized by Calcium Deposits in the Kidneys

Nephrocalcinosis is a medical condition where calcium deposits form in the kidney tissue, leading to an increase in calcium levels in the kidneys. This condition can impair kidney function and may cause acute or chronic kidney injury.

Causes of Nephrocalcinosis

Nephrocalcinosis can be caused by various conditions, including:

• High levels of calcium in the blood or urine
• Metabolic disorders, such as hyperparathyroidism
• Genetic disorders, like primary and secondary oxalosis
• Infections, such as pyelonephritis
• Tissue necrosis due to neoplasm, infarction, or infection

Types of Nephrocalcinosis

There are two forms of nephrocalcinosis: dystrophic calcification and metastatic calcification. Dystrophic calcification occurs when calcium deposition arises from tissue necrosis secondary to neoplasm, infarction, or infection.

Symptoms and Effects

Nephrocalcinosis can cause acute or chronic kidney injury, and may be incidentally detected radiographically in a patient with normal kidney function. The condition usually involves the renal medulla (in 97% of patients) or, less often, the cortex.

References:

• [1] Nephrocalcinosis is related to, but not the same as, kidney stones (nephrolithiasis). Conditions that can cause nephrocalcinosis include... (Source: #14)
• [2] Nephrocalcinosis may cause acute or chronic kidney injury or be incidentally detected radiographically in a patient with normal kidney function. (Source: #11)
• [3] The term nephrocalcinosis is used to describe the deposition of both calcium oxalate and calcium phosphate. (Source: #12)

Early Signs and Symptoms

In many cases, nephrocalcinosis does not cause any noticeable symptoms, and the condition may only be detected through imaging tests or other diagnostic procedures [1]. However, as the disease progresses, later symptoms related to nephrocalcinosis may develop, which can include:

• Kidney failure: Long-term kidney damage can lead to chronic kidney failure, which can cause a range of symptoms, including fatigue, swelling, and changes in urination patterns [2][9].
• Obstructive uropathy: The buildup of calcium deposits in the kidneys can obstruct the flow of urine, leading to symptoms such as pain, burning sensations while urinating, and frequent urination [2][9].
• Urinary tract stones: Nephrocalcinosis is often associated with kidney stones (nephrolithiasis), which can cause severe pain, nausea, vomiting, and blood in the urine [3][4][13][14].

Other Possible Symptoms

In some cases, people with nephrocalcinosis may experience additional symptoms, including:

• Blood in the urine: This can be a sign of kidney damage or disease [3][4][13].
• Fever and chills: These symptoms can indicate an underlying infection or inflammation [3][4][13].
• Nausea and vomiting: These symptoms can occur due to pain, discomfort, or other complications related to the condition [3][4][13].

Important Note

It's essential to note that many people with nephrocalcinosis do not experience any noticeable symptoms in the early stages of the disease. If you suspect you may have this condition, it's crucial to consult a healthcare professional for proper diagnosis and treatment.

References:

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Nephrocalcinosis can be diagnosed using various imaging tests, as well as blood and urine tests.

Imaging Tests

• Ultrasound is a sensitive diagnostic test for both cortical and medullary nephrocalcinosis, demonstrating the parenchymal calcifications before they can be visualized on plain radiographs [5].
• CT scanning is also a sensitive diagnostic test for nephrocalcinosis, showing the calcifications in the kidneys [5].
• Abdominal CT scan and ultrasound of the kidney are tests that may be done to diagnose nephrocalcinosis [3][4].

Blood Tests

• Serum calcium, phosphate, and albumin levels can help diagnose nephrocalcinosis by checking for imbalances in these minerals [6].
• Blood urea nitrogen (BUN) and serum creatinine levels can also be checked to assess kidney function [6].

Urine Tests

• Urinalysis may be done to check for crystals and red blood cells, which can indicate nephrocalcinosis [9].

Other Tests

• Estimated glomerular filtration rate (eGFR) can be calculated to assess kidney function [6].
• High-resolution ultrasonography is considered the optimal imaging method for detecting and monitoring nephrocalcinosis [8].

It's worth noting that while these tests can help diagnose nephrocalcinosis, the diagnostic correlation between currently used techniques is imperfect, and there is considerable interobserver variability with respect to the interpretation of test results [2].

Nephrocalcinosis, a disorder characterized by excessive calcium deposition in the kidneys, can be treated through various methods, including medication.

Medications Used to Treat Nephrocalcinosis

• Hydrochlorothiazide: A thiazide diuretic that is commonly used to treat nephrocalcinosis. It helps correct serum calcium levels and reduce calcium loss from bone [1].
• Calcitonin: Indicated for the treatment of hypercalcemia, which can be associated with nephrocalcinosis [1].

Other Medications

• Potassium citrate: Preferred over sodium citrate due to its lower risk of increasing sodium intake, which could exacerbate kidney issues [8].
• Bisphosphonates: Used to treat hypercalcemia and decrease calcium loss from bone, although their direct use in nephrocalcinosis treatment is less clear [1].

Important Considerations

• Treatment for nephrocalcinosis often involves addressing the underlying condition causing the disorder.
• Dietary changes or vitamin supplements may also be recommended as part of a comprehensive treatment plan [5].
• In some cases, medications like furosemide may be associated with nephrocalcinosis, highlighting the need to carefully manage these conditions [7].

References

[1] Context 1 and 2 [4] Context 4 [5] Context 5 [8] Context 8

Nephrocalcinosis, also known as renal medullary nephrocalcinosis, is a condition characterized by the deposition of calcium salts in the kidneys. When diagnosing nephrocalcinosis, it's essential to consider various differential diagnoses that can present with similar symptoms.

Possible Differential Diagnoses:

• Bartter Syndrome: A rare genetic disorder that affects the kidneys' ability to regulate electrolytes and acid-base balance, leading to excessive calcium excretion in the urine [1].
• Dent's disease: A rare X-linked recessive disorder characterized by proximal tubule dysfunction, leading to hypercalciuria and nephrocalcinosis [2].
• Distal renal tubular acidosis (RTA): A condition where the kidneys are unable to properly regulate acid-base balance, leading to excessive calcium excretion in the urine [3].
• Drug exposure (topiramate): Certain medications, such as topiramate, can cause nephrocalcinosis as a side effect [4].

Other Considerations:

• Hypercalcemia: Elevated levels of calcium in the blood can lead to nephrocalcinosis [5].
• Medullary sponge kidney (MSK): A benign condition characterized by cystic dilation of the renal collecting ducts, which can lead to nephrocalcinosis [6].

Classification and Causes:

Nephrocalcinosis is classified into three types: cortical, medullary, or diffuse. The various causes of nephrocalcinosis in children are summarized in Tables 71.7 and 71.9 [7]. Nephrocalcinosis can also be caused by other conditions such as autonomous hyperparathyroidism, distal RTA, and MSK [8].

References:

[1] May 9, 2024 — Differential Diagnoses · Bartter Syndrome [2] Mar 23, 2023 — Renal medullary nephrocalcinosis is the commonest form of nephrocalcinosis and refers to the deposition of calcium salts in the medulla of the kidney. [3] May 9, 2024 — This opposing effect of hypercalcemia and parathyroid hormone has been used in the differential diagnosis of hypercalcemia, because serum ... [4] Jul 1, 2023 — Nephrocalcinosis is a disorder in which there is too much calcium deposited in the kidneys. It is common in premature babies. [5] Oct 25, 2024 — Nephrocalcinosis may cause acute or chronic kidney injury or be incidentally detected radiographically in a patient with normal kidney function. [6] by L Shavit · 2015 · Cited by 98 — It shows that autonomous hyperparathyroidism, distal renal tubular acidosis (dRTA), and medullary sponge kidney (MSK) are the most frequent clinical diagnoses ... [7] Nephrocalcinosis is classified as cortical, medullary or diffuse. The various causes of nephrocalcinosis in children are summarised in Tables 71.7 and 71.9. [8] Feb 21, 2022 — Nephrocalcinosis, previously known as Anderson-Carr kidney or Albright calcinosis, refers to the deposition of calcium salts in the parenchyma of the kidney.