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    Nephrocalcinosis

    Nephrocalcinosis is a disorder in which there is too much calcium deposited in the kidneys. This condition is common in premature babies.

    Causes

    Any disorder that leads to high levels of calcium in the blood or urine may lead to nephrocalcinosis. In nephrocalcinosis, calcium deposits form in the kidney tissue itself. Most of the time, both kidneys are affected.

    Nephrocalcinosis is related to, but not the same as, kidney stones (nephrolithiasis).

    Conditions that can cause nephrocalcinosis include:

    • Alport syndome
    • Bartter syndrome
    • Chronic glomerulonephritis
    • Familial hypomagnesemia
    • Medullary sponge kidney
    • Primary hyperoxaluria
    • Renal transplant rejection
    • Renal tubular acidosis
    • Renal cortical necrosis

    Other possible causes of nephrocalcinosis include:

    • Ethylene glycol toxicity
    • Hypercalcemia (excess calcium in the blood) due to hyperparathyroidism
    • Use of certain medications, such as acetazolamide, amphotericin B, and triamterene
    • Sarcoidosis
    • Tuberculosis of the kidney and infections related to AIDS
    • Vitamin D toxicity

    Symptoms

    There are generally no early symptoms of nephrocalcinosis beyond those of the condition causing the problem.

    People who also have kidney stones may have:

    • Blood in the urine
    • Fever and chills
    • Nausea and vomiting
    • Severe pain in the belly area, sides of the back (flank), groin, or testicles

    Later symptoms related to nephrocalcinosis may be associated with chronic kidney failure.

    Exams and Tests

    Nephrocalcinosis may be discovered when symptoms of renal insufficiency, kidney failure, obstructive uropathy, or urinary tract stones develop.

    Imaging tests can help diagnose this condition. Tests that may be done include:

    • Abdominal CT scan
    • Ultrasound of the kidney

    Other tests that may be done to diagnose and determine the severity of associated disorders include:

    • Blood tests to check levels of calcium, phosphate, uric acid, and parathyroid hormone
    • Urinalysis to see crystals and check for red blood cells
    • 24-hour urine collection to measure acidity and levels of calcium, sodium, uric acid, oxalate, and citrate

    Treatment

    The goal of treatment is to reduce symptoms and prevent more calcium from collecting in the kidneys.

    Treatment will involve methods to reduce abnormal levels of calcium, phosphate, and oxalate in the blood and urine.

    If you take medicine that causes calcium loss, your doctor will usually tell you to stop taking it. Never stop taking any medicine before talking to your doctor.

    Other symptoms, included kidney stones, should be treated as appropriate.

    Outlook (Prognosis)

    What to expect depends on the complications and cause of the disorder.

    Proper treatment may help prevent further deposits in the kidneys. However, there is usually no way to remove deposits that have already formed. Extensive deposits of calcium in the kidneys do NOT always mean severe damage to the kidneys.

    • Acute renal failure
    • Chronic renal failure
    • Kidney stones
    • Obstructive uropathy (acute or chronic, unilateral or bilateral)

    When to Contact a Medical Professional

    Call your health care provider if you know you have a disorder that causes high levels of calcium in your blood and urine, or if you develop symptoms of nephrocalcinosis.

    Prevention

    Prompt treatment of disorders that lead to nephrocalcinosis, including renal tubular acidosis, may help prevent it from developing.

    References

    Curhan GC. Nephrolithiasis. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, Pa: Elsevier Saunders; 2011:chap 128.

    Elder JS. Urinary lithiasis. In: Kliegman RM, Stanton BF, St. Geme JW III, et al.,eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Pa:Elsevier Saunders; 2011:chap 541.

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    • Male urinary system

      illustration

      • Male urinary system

        illustration

      Tests for Nephrocalcinosis

        Review Date: 10/2/2013

        Reviewed By: Scott Miller, MD, Urologist in private practice in Atlanta, Georgia. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.

        The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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