Pediatria pre prax 6/2022

Nephrocalcinosis – etiology, diagnostics, treatment

Nephrocalcinosis is caused by the accumulation of calcium deposits in the renal parenchyma. According to the place of involvement, medullary, cortical and diffuse form can be distinguished. Clinically it is often asymptomatic. However, in some cases it can progress to renal failure. Nephrocalcinosis is always just a symptom of another underlying disease. Etiology includes a wide spectrum of pathomechanisms. Hypercalciuria and/or hyperphosphaturia and/or hyperoxaluria are among the most important predisposing factors. The gold standard of diagnostics of nephrocalcinosis is ultrasonography. The examination of a patient with nephrocalcinosis includes a comprehensive urinalysis, kidney functions, hematological and biochemical parameters as well as parameters of acid-base balance. In the differential diagnostics of the principal causes, abnormalities of calcium-phosphate metabolism, congenital metabolic disorders, hereditary tubulopathies and others are considered. The most effective treatment is the treatment of the underlying disease. Symptomatic therapy aims to reduce urinary calcium excretion (diet, diuretics, and others) and increase the solubility of calcium deposits in the kidneys (sufficient fluids, alkalization treatment and others).

Keywords: nephrocalcinosis, hypercalciuria, hyperoxaluria, renal deposits