eMedicine Specialties > Radiology > Genitourinary

Nephrocalcinosis: Follow-up

Author: Ali Nawaz Khan, MBBS, FRCS, FRCP, FRCR, Consultant Radiologist, North Manchester General Hospital, The Pennine Acute NHS Trust, Manchester UK
Coauthor(s): Sumaira MacDonald, MBChB, PhD, MRCP, FRCR, Lecturer, Sheffield University Medical School; Endovascular Fellow, Sheffield Vascular Institute; Muthusamy Chandramohan, MBBS, DMRD, FRCR, Consultant Radiologist, Bradford Teaching Hospitals, UK; Hemalatha Chandramohan, MBBS, Staff Physician, Department of Geriatric Medicine, Stepping Hill Hospital, United Kingdom
Contributor Information and Disclosures

Updated: Jul 10, 2008

Intervention

Extracorporeal shock wave lithotripsy (ESWL) may be indicated in cases of intrapelvic renal stones (nephrocalcinosis). Parathyroidectomy may be required to control hypercalcemia that is caused by hyperparathyroidism. This technique is good for stones smaller than 5 mm, satisfactory for stones 5-10 mm, and rarely used for stones larger than 10 mm because of the possibility of the debris load causing steinstrasse.

Medicolegal Pitfalls

  • Nephrocalcinosis found incidentally may be the presenting feature of a variety of inborn errors of metabolism, and the radiologist may be the first to suggest a diagnosis based on the pattern and distribution of renal parenchymal disease. Therefore, the radiologist must be aware of the causes of nephrocalcinosis.
  • A misdiagnosis of nephrocalcinosis may lead to irreversible renal failure that causes unnecessary suffering for the patient. Early recognition is important because changes are usually reversible. Differentiating between nephrolithiasis and nephrocalcinosis is also important because the 2 conditions are managed differently, although in some conditions, the 2 may coexist.10,22

Special Concerns

  • Nephrocalcinosis is rare in pediatric patients, but it may occur in neonates and premature babies.23,24,25,26,27,28 Recognition is therefore important to prevent renal failure and long-term effects.
  • Nephrocalcinosis may be the first manifestation of many familial metabolic disorders, or it may appear as a complication of drug therapy, particularly treatment with diuretics. Prompt recognition is therefore important to modulate treatment.
 


More on Nephrocalcinosis

Overview: Nephrocalcinosis
Imaging: Nephrocalcinosis
Follow-up: Nephrocalcinosis
Multimedia: Nephrocalcinosis
References
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References

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Further Reading

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Keywords

nephrocalcinosis, male urogenital disease, urologic diseases, kidney disease, medullary sponge kidney, renal lithiasis, urolithiasis, medullary calcification, diffuse renal calcification, nephrolithiasis, medullary nephrocalcinosis, cortical nephrocalcinosis,  hypercalcemia, hypercalciuria, hyperoxaluria, Bartter syndrome, hyperparathyroidism, primary, hyperparathyroidism,secondary,  Butler-Albright disease

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Contributor Information and Disclosures

Author

Ali Nawaz Khan, MBBS, FRCS, FRCP, FRCR, Consultant Radiologist, North Manchester General Hospital, The Pennine Acute NHS Trust, Manchester UK
Ali Nawaz Khan, MBBS, FRCS, FRCP, FRCR is a member of the following medical societies: American Institute of Ultrasound in Medicine, Royal College of Physicians, Royal College of Physicians and Surgeons of the United States, Royal College of Radiologists, and Royal College of Surgeons of England
Disclosure: Nothing to disclose.

Coauthor(s)

Sumaira MacDonald, MBChB, PhD, MRCP, FRCR, Lecturer, Sheffield University Medical School; Endovascular Fellow, Sheffield Vascular Institute
Sumaira MacDonald, MBChB, PhD, MRCP, FRCR is a member of the following medical societies: British Medical Association, Royal College of Physicians, and Royal College of Radiologists
Disclosure: Nothing to disclose.

Muthusamy Chandramohan, MBBS, DMRD, FRCR, Consultant Radiologist, Bradford Teaching Hospitals, UK
Disclosure: Nothing to disclose.

Hemalatha Chandramohan, MBBS, Staff Physician, Department of Geriatric Medicine, Stepping Hill Hospital, United Kingdom
Disclosure: Nothing to disclose.

Medical Editor

Steven Perlmutter, MD, FACR, Associate Professor of Clinical Radiology, School of Medicine at Stony Brook University; Medical Director of Radiology, Peconic Bay Medical Center
Steven Perlmutter, MD, FACR is a member of the following medical societies: American College of Radiology, American Institute of Ultrasound in Medicine, American Medical Association, American Roentgen Ray Society, Association of Program Directors in Radiology, Association of University Radiologists, Medical Society of the State of New York, Radiological Society of North America, Society of Breast Imaging, Society of Nuclear Medicine, and Society of Uroradiology
Disclosure: Nothing to disclose.

Pharmacy Editor

Bernard D Coombs, MB, ChB, PhD, Consulting Staff, Department of Specialist Rehabilitation Services, Hutt Valley District Health Board, New Zealand
Disclosure: Nothing to disclose.

Managing Editor

Joshua A Becker, MD, Professor, Department of Radiology, New York University School of Medicine
Joshua A Becker, MD is a member of the following medical societies: Society of Uroradiology
Disclosure: Nothing to disclose.

CME Editor

Robert M Krasny, MD, Consulting Staff, Department of Radiology, Resolution Imaging Medical Corporation
Robert M Krasny, MD is a member of the following medical societies: American Roentgen Ray Society and Radiological Society of North America
Disclosure: Nothing to disclose.

Chief Editor

Eugene C Lin, MD, Consulting Radiologist, Virginia Mason Medical Center; Clinical Assistant Professor of Radiology, University of Washington School of Medicine
Eugene C Lin, MD is a member of the following medical societies: American College of Nuclear Medicine, American College of Radiology, Radiological Society of North America, and Society of Nuclear Medicine
Disclosure: Nothing to disclose.

 
 
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