Nephrocalcinosis

• What is Nephrocalcinosis
• Statistics on Nephrocalcinosis
• Risk Factors for Nephrocalcinosis
• Progression of Nephrocalcinosis
• Symptoms of Nephrocalcinosis
• Clinical Examination of Nephrocalcinosis
• How is Nephrocalcinosis Diagnosed?
• Prognosis of Nephrocalcinosis
• How is Nephrocalcinosis Treated?
• Nephrocalcinosis References

What is Nephrocalcinosis

Nephrocalcinosis is a disease affecting the kidney.

Deposition of calium salts within the tissues of the kidney.

Statistics on Nephrocalcinosis

Radiologic detection is required to make the clinical diagnosis and it is noted in about 0.1% of radiographs of the kidney. This condition is detected on microscopic analysis in about 10% of autopsies.

Risk Factors for Nephrocalcinosis

There are many causes of this condition, each with their own predisposing factors.

Progression of Nephrocalcinosis

The natural course of this condition depends on the cause. Some causes such as medullary sponge kidney have a dramatic appearance on x-ray but uncommonly progression to long-term renal disease. The resolution of other causes such as hyperparathyroidism may result in the complete resolution of renal disease. Other causes, however, such as hyperoxaluria will progress to chronic renal failure over time.

Typically, the condition of nephrocalcinosis will result in a slow decline in renal function over time.

How is Nephrocalcinosis Diagnosed?

General investigation of nephrocalcinosis aims to assess the function of the kidneys as well as detect complications such as urinary tract infection and renal stone formation. This may require anumber of bloods tests to be taken.

Prognosis of Nephrocalcinosis

The prognosis of this condition is largely dependent on its cause, as outlined in natural history. The vast majority of patients with this disorder will experience a slow decline in renal function over many years, and may develop renal failure if the condition is present for long enough.

How is Nephrocalcinosis Treated?

The aims of management include:

1. Treatment of the underlying cause: The resolution of some causes such as hyperparathyroidism may result in the complete resolution of renal disease. Reversible causes must be sought and treated where possible.

2. Prevention of complications: Maintain adequate fluid intake to prevent further calcium deposition, development of renal failure and development of renal stones.

3. Specific therapy: The rare condition of hyperoxaluria may require the restriction of oxalate from the diet and the use of medications such as pyridoxine. Calcium supplements and use of medium chain fats may also help with this condition.

Nephrocalcinosis References

[1] Braunwald, Fauci, Kasper, Hauser, Longo, Jameson. Harrison’s Principles of Internal Medicine. 15th Edition. McGraw-Hill. 2001.
[2] Cotran, Kumar, Collins 6th edition. Robbins Pathologic Basis of Disease. WB Saunders Company. 1999.
[3] Haslet C, Chiliers ER, Boon NA, Colledge NR. Principles and Practice of Medicine. Churchill Livingstone 2002.
[4] Hurst JW (Editor-in-chief). Medicine for the practicing physician. 4th edition Appleton and Lange 1996.
[5] Kumar P, Clark M. CLINICAL MEDICINE. WB Saunders 2002 Pg 427-430.
[6] Longmore M, Wilkinson I, Torok E. OXFORD HANDBOOK OF CLINICAL MEDICINE. Oxford Universtiy Press. 20013. McLatchie G and LEaper DJ (editors). Oxford Handbook of Clinical Surgery 2nd Edition. Oxford University Press 2002.
[7] Raftery AT Churchill’s pocketbook of Surgery. Churchill Livingsone 2001.