Nephrocalcinosis

The term 'nephrocalcinosis' means diffuse renal parenchymal calcification that is detectable radiologically. The condition is typically painless. Hypertension and renal impairment commonly occur.

Dystrophic calcification occurs following renal cortical necrosis. In hypercalcaemia and hyperoxaluria, deposition of calcium oxalate results from the high concentration of calcium and oxalate within the kidney.

There are generally no early symptoms. Later symptoms related to nephrocalcinosis and associated disorders.

Presentation can range from incidental detection on abdominal x-rays or ultrasounds performed for another reason, to life threatening.

In renal tubular acidosis failure of urinary acidification and a reduction in urinary citrate excretion both favour calcium phosphate and oxalate precipitation, since precipitation occurs more readily in an alkaline medium and the calcium-chelating action of urinary citrate is reduced.

NC may be a consequence of neonatal treatments such as diuretics and steroids, or may just be a marker of neonatal illness. Nutritional factors are thought to contribute, particularly high intakes of calcium in the diet which may not necessarily be absorbed and instead are excreted in urine.

May lead to uncontrolled hypertension, renal infection, scarring, renal colic, defects of renal tubular function and renal failure.

The prognosis depends mainly on the aetiology of the nephrocalcinosis.

Medications that enhance calcium excretion should be discontinued. Never discontinue any medications without consulting your health care provider.

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