What is the definition of Nephrocalcinosis?

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

What are the causes for Nephrocalcinosis?

Any disorder that leads to high levels of calcium in the blood or urine may lead to nephrocalcinosis. In this disorder, calcium deposits 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 (RTA)
  • Renal cortical necrosis

Other possible causes of nephrocalcinosis include:

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

What are the symptoms for Nephrocalcinosis?

Most of the time, there are 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 long-term (chronic) kidney failure.

What are the current treatments for Nephrocalcinosis?

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

Treatment will involve methods to reduce abnormal levels of calcium, phosphate, and oxalate in the blood and urine. Options include making changes in your diet and taking medicines and supplements.

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

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

What is the outlook (prognosis) for Nephrocalcinosis?

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

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

What are the possible complications for Nephrocalcinosis?

Complications may include:

  • Acute kidney failure
  • Long-term (chronic) kidney failure
  • Kidney stones
  • Obstructive uropathy (acute or chronic, unilateral or bilateral)

When should I contact a medical professional for Nephrocalcinosis?

Call your provider if you know you have a disorder that causes high levels of calcium in your blood and urine. Also call if you develop symptoms of nephrocalcinosis.

How do I prevent Nephrocalcinosis?

Prompt treatment of disorders that lead to nephrocalcinosis, including RTA, may help prevent it from developing. Drinking plenty of water to keep the kidneys flushed and draining will help prevent or decrease stone formation as well.

Male urinary system

REFERENCES

Bushinsky DA. Kidney stones. In: Melmed S, Auchus, RJ, Goldfine AB, Koenig RJ, Rosen CJ, eds. Williams Textbook of Endocrinology. 14th ed. Philadelphia, PA: Elsevier; 2020:chap 32.

Chen W, Monk RD, Bushinsky DA. Nephrolithiasis and nephrocalcinosis. In: Feehally J, Floege J, Tonelli M, Johnson RJ, eds. Comprehensive Clinical Nephrology. 6th ed. Philadelphia, PA: Elsevier; 2019:chap 57.

Tublin M, Levine D, Thurston W, Wilson SR. The kidney and urinary tract. In: Rumack CM, Levine D, eds. Diagnostic Ultrasound. 5th ed. Philadelphia, PA: Elsevier; 2018:chap 9.

Vogt BA, Springel T. The kidney and urinary tract of the neonate. In: Martin RJ, Fanaroff AA, Walsh MC, eds. Fanaroff and Martin’s Neonatal-Perinatal Medicine. 11th ed. Philadelphia, PA: Elsevier; 2020:chap 93.