Ultrasound is a sign of medullary nephrocalcinosis. Nephrocalcinosis of the kidneys. Video: kidney therapy at home

Many different factors of the environment in which humanity lives, provoke the occurrence of metabolic changes in the body. As a result of such violations, new compounds are formed, which over time accumulate in certain organs and lead to the development of various diseases.

Renal nephrocalcinosis - what is it?

Nephrocalcinosis is a pathological inflammatory process characterized by diffuse precipitation of calcium phosphate salts on the walls of the renal tubules or in their parenchyma itself.

This disease often develops as a result of impaired calcium metabolism in the human body for any reason. Calcium salts crystallize and are deposited in the tissues of organs, mainly in the kidney tissue, sclerosis (scarring) develops. Nephrocalcinosis in almost all variants of development leads to renal failure (chronic).

Types of pathogenetic aspects of the development of the disease

There are two types of nephrocalcinosis, which are distinguished by etiological factors:

With the development of sclerosis and the deposition of calcium elements on the previously unchanged renal parenchyma, we can talk about the primary form of nephrocalcinosis;
In the secondary form of the disease, the sediment is fixed on the scar tissue of the kidney. This type of nephrocalcinosis begins simultaneously from the cortical part and from the side of the epithelium of the tubules.

According to the localization of calcifications in the kidney, the disease is classified:

Cortical nephrocalcinosis (calcium deposits are formed mainly in the cortical layer of the kidney);
Medullary (calcium precipitates in the areas of the renal pyramids).

The formation of calcium phosphate and its fixation in the kidneys is caused by hypercalcemia and hypercalciuria (an increase in the concentration of calcium in the blood and urine). Due to the increased load, the kidneys cannot cope with their main functions; the sediment is fixed inside the epithelial cells of the renal tubules.

Then dystrophic changes in the epithelium occur, calcium salts pass into the interstitial part of the renal tissue or into the lumen of the tubules, clogging them (cylinders). In the parenchyma, metastatic foci of calcium fixation provoke the activation of the immune system, which leads to the replacement of normal kidney connective tissue.

Inflammatory changes occur due to blockage of the kidney tubules and disruption of the normal passage of urine. Often, as a complication, pyelonephritis occurs, as well as hydronephrosis of the kidney.

Deposition of calcium salts in the kidney

Causes

Causal factors for the development of primary nephrocalcinosis:

Increasing the intake of calcium in the human body. The cause may be congenital tubulopathy in children, neonatal nephropathy, Burnett's syndrome and Lightwood-Fanconia, and some other diseases.
Pathological conditions in which calcium is intensively removed from the bones: osteoporosis, hormonal imbalance (hyperparathyroidism), metastatic processes in the skeletal system and myeloma, an increase in the level of thyroid hormones.
Increasing the level of vitamin D in the body, which is responsible for increasing the concentration of calcium in the blood.

The reasons for the development of the secondary form of nephrocalcinosis:

Acute violation of the blood supply to the cortical layer of the kidneys.
Radiation damage to the kidneys.
The toxic effect of mercury on the body.
Overdose or use of excessive amounts of phenacetin, sulfonamides.
Abuse of various diuretics.
Violations associated with a change in the acid-base balance of the blood.

Signs and symptoms

Nephrosclerosis and the loss of calcium salts in the renal parenchyma can have many different clinical manifestations.

First of all, there are signs of calcium intoxication of the body:

Nausea, bouts of vomiting;
Weakness and malaise, thirst;
Headaches and pains in the region of the heart;
Cardiac arrhythmias, changes in the ECG (shortening of the period of contraction of the heart);
Itching of the skin, dryness and signs of flaking;
The joints are deformed, painful sensations appear in them when moving;
The motility of the intestines and stomach is impaired, from this painful abdominal cramps and constipation appear.
Emotional lability;
Signs of hypertension may appear;

If the tubules of the kidneys and their epithelial cells are affected, then painful sensations occur in the lumbar region, pyelonephritis or hydronephrosis may develop.

In case of blockage of the urinary tract, clinical signs of urolithiasis appear.

Due to the pathological calcification of the kidney tubules, their sensitivity to the influence of antidiuretic hormone decreases, as a result, the following symptoms appear:

Persistent decrease in the osmotic pressure of urine;
Increased daily urine output;
Polydipsia (as a result of intense thirst).

Diagnostics

Necessary laboratory and instrumental methods for the diagnosis of renal nephrocalcinosis:

Nephrocalcinosis at the initial stages of its development has practically no clinical manifestations. In the early stages of the development of the disease, the most informative diagnostic method, but also the most invasive, is a kidney biopsy using a puncture technique.
Ultrasound examination (ultrasound) is considered a fairly informative method for diagnosing kidney calcification in the early stages. On the resulting image, when scanning in various planes and sections, you can see a symptom of permedullary rings of high echogenicity. Also, nephrocalcinosis of the kidneys during ultrasound is expressed by the following signs: (with a cortical form) linear hyperechoic neoplasms or diffuse inclusion.
X-ray and CT are effective already in the late stages of calcification, when triangular pyramids or linear calcifications in the cortex of the kidney are clearly visualized in the image.
To determine the etiological and pathogenetic conditions for the development of the disease in children and adults, blood and urine are taken to determine the content of calcium and phosphorus in them.
A general analysis of biological fluids (urine and blood), their biochemistry and Sulkovichka's test (calciuria level) are carried out.
It is very important to assess the functional state of the kidneys; for this, creatinine clearance is determined, and the level of alkaline phosphatase is assessed.
In order to determine the form of the disease (primary or secondary), the level of parathyroid hormone in the patient's blood is examined.

The video shows signs of early kidney nephrocalcinosis:

Treatment

The attending doctor, having fully studied all the results of the patient's research, prescribes drug treatment, the purpose of which is to eliminate the root cause of the disease:

With severe dehydration of the body and violation of acid-base balance, it is necessary to carry out intravenous drip infusion of solutions (sodium or potassium citrate, potassium aspartate, sodium hydrogen carbonate or sodium chloride).
If hypercalcemia is not significant, treatment with folk remedies, which necessarily include a diet, is acceptable.
Prescribe the intake of vitamins of group B orally or in an injection form.
With the progression of renal failure or the development of a coma, it is carried out.
A solution of magnesium sulfate or sodium phosphate is injected intravenously with hypercalcemia.
Perhaps the appointment of hormonal drugs (prednisone or thyrocalcitonin).
When signs of pyelonephritis appear, treatment appropriate to this disease.

Features of diet therapy

To reduce the level of calcium in the blood, it is very important to exclude the following foods: sunflower oil, mustard, sesame seeds, various types of cheeses. You can not use wheat flour, bran, almonds, dairy products, oatmeal.

You should adhere to diet number 7, which causes the elimination of toxins from the body.

From the folk methods of treating kidney diseases, strawberries, strawberry leaves in the form of a decoction can be noted. The broth is taken orally for about 10 days daily.

Gooseberry, viburnum and sea buckthorn berries have a good effect (anti-inflammatory and diuretic effect).

The prepared broth for warm sitz baths from birch and sage leaves improves blood circulation in the vascular bed of the kidneys, relieves inflammation.

Prohibited foods for kidney nephrocalcinosis

Forecast

With the progression of renal nephrocalcinosis, the prognosis for the future is unfavorable, since the development of renal failure and uremia is inevitable. With timely diagnosis of the disease and proper treatment, the prognosis for the development of the disease is more favorable. It is impossible to cure nephrocalcinosis with folk remedies, so it is very important to see a doctor in time.

Nephrocalcinosis- a disease that belongs to the group of calcifications. Calcification, also known as calcareous dystrophy, is a form of pathology of calcium metabolism in the body: calcium salts fall out of liquids (they were dissolved in liquids) into a sediment, deposited in the interstitial tissue and in cells.

Nephrocalcinosis is a variant of metastatic calcification, in which calcium salts are diffusely deposited in the kidney tissue, which causes their inflammatory-sclerotic changes and renal failure.

Types of nephrocalcinosis by clinical manifestations:

primary
secondary

With the primary changes in the kidneys are not observed, and with the secondary, kidney pathology occurs along with the processes of precipitation of calcium salts. Nephrocalcinosis can occur, for example, with lactic acid syndrome or Burnett's syndrome. It is likely in children who are switched from natural feeding to herbal supplemented cow's milk. Read more about the reasons below.

What provokes / Causes of nephrocalcinosis:

Among the causes of primary nephrocalcinosis are:

conditions in which too much calcium enters the body (familial and idiopathic hypercalcemia of newborns, hypervitaminosis D, Burnett's syndrome, Lightwood-Fanconi syndrome, Addison's disease, sarcoidosis, excessive intravenous calcium salts)
conditions in which calcium is mobilized from bones (tumors of bones and some organs, hyperparathyroidism, myeloma, tumor metastases in bones, post-castration and corticosteroid osteoporosis, postmenopausal osteoporosis, osteomyelitis, multiple bone fractures, Paget's disease, neuroplegia, immobilization)
hypophosphatasia (calcium binding in bones is impaired)
oxalosis, cystinosis, calciphylaxis, in which calcium unnecessary there normally is deposited in the tissues
tubulopathy and various diseases that occur with acidosis (Buttler-Albright chronic tubular acidosis, Lightwood transient tubular acidosis, Lowe's oculocereborenal syndrome, glucose-phosphate-aminoaciduria de Toni-Debre-Fanconi, hyperchloremic acidosis)

Secondary nephrocalcinosis: causes

Among the most likely reasons are:

radiation nephrosclerosis
ischemic cortical renal necrosis
abuse of sulfonamides, thiazide diuretics, phenacetin, ethacrine diuretics, anthranil diuretics
uncontrolled use of amphotericin
poisoning with mercury salts

Nephrocalcinosis can be caused by renal and extrarenal disorders of acid-base balance. It is mainly metabolic and respiratory acidosis, in rare cases it is metabolic alkalosis. With these diseases, the level of calcium in the blood rises, and its excretion in the urine increases. The degree of calciuria can be a maximum of 400-600 milligrams in 24 hours.

Pathogenesis (what happens?) During nephrocalcinosis:

Pathogenesis of calcifications

The matrix for calcium salts inside cells is lysosomes and mitochondria. Outside the cells, these are collagen and elastic fibers plus glycosaminoglycans of the main substance of the interstitial tissue. Calcium salts can be deposited in the form of grains, foci of lime, which are more or less common in different cases. In areas with lime, bone tissue can form, and around it there will be inflammation and a fibrous capsule.

Local and general factors play a role in the pathogenesis of calcifications. Therefore, the forms of calcification, in addition to the criterion for the location of calcifications, are distinguished by pathogenetic factors. Calcification can be metastatic, metabolic, and dystrophic, which is also known as (petrification).

Pathogenesis of nephrocalcinosis

An abnormally large influx of calcium occurs to the kidneys; it accumulates in the epithelial cells of the human kidneys. When too much intracellular calcium is collected, the phenomena of cell degeneration occur. The deposited calcium enters the interstitial space or the lumen of the tubules. In this process, cylinders are formed that overlap the tubules, therefore, their dilatation and atrophy occurs. Salt deposits in the interstitium cause a lymphoproliferative reaction, then nephrosclerosis occurs.

With nephrocalcinosis, infection and the formation of stones occur, therefore this disease becomes the source of pyelonephritis and / or hydronephrosis. The pathogenesis of primary nephrocalcinosis in children and adults is characterized by the fact that the proximal nephron is affected first, and the glomerulus and distal are affected later. If nephrocalcinosis is secondary, then calcium is deposited simultaneously in the distal nephron.

Symptoms of Nephrocalcinosis:

With nephrocalcinosis, there is usually an underlying disease. Therefore, two groups of symptoms appear at once, as well as concomitant hypercalcemia. Calcium intoxication causes the following symptoms:

fatigue
general weakness
vomit
dry skin
thirst
constipation
joint deformity
joint pain
mental instability
keratoconjunctivitis
seizures
shortening the duration of systole on the electrocardiogram

With kidney damage, when the transport of substances in the tubules is disrupted and their sensitivity to antidiuretic hormone is lost, there are:

isostenuria
polyuria
attacks of renal colic are likely (with the discharge of calculi)
lower back pain

Often there are persistent changes in the urinary sediment, it contains a large number of bacteria, leukocytes, salt casts and erythrocytes. Later, edema, proteinuria, and arterial hypertension are recorded. In this period, as a rule, symptomatic and laboratory signs of kidney failure appear.

Complications:

Chronic renal failure
Obstructive uropathy
Stones in the kidneys

Diagnostics of the nephrocalcinosis:

Diagnosis of nephrocalcinosis at the stage of its appearance is based on information obtained using the basis of a puncture biopsy of the kidney. Such a method as plain radiography is relevant only in severe cases, when calcification of the renal pyramids is significantly pronounced.

To approximately determine the degree of calciuria, diagnosticians sometimes use the Sulkovich test. To clarify the cause of the disease, the patient's urine and blood are examined for the content of calcium and phosphorus, the activity of parathyroid hormone in the blood, alkaline phosphatase is determined. It is necessary to identify the excretion of hydroxyproline in the urine, acid-base balance, creatinine and phosphate clearance.

When diagnosed, nephrocalcinosis is distinguished from the spongy kidney, in which the cystic spaces are filled with condensate of calcium salts.

Treatment of Nephrocalcinosis:

It is necessary to eliminate the cause of the violation of calcium metabolism in the body as soon as possible. With severe dehydration, an infusion of sodium bicarbonate or citrate solution, potassium citrate and asparaginate is made with acidosis, and with alkalosis, sodium chloride and ammonium chloride are injected.

If hypercalcemia is moderate, the patient is advised to adhere to a diet plan with foods that have little or no calcium. Vitamin B6 and magnesium sulfate solution infusion are credited. The treatment of acute hypercalcemia is the infusion of a solution of magnesium sulfate, sodium phosphate, sodium EDTA. Doctors may prescribe thyrocalcitonin or prednisolone.

Treatment of progressive renal failure is carried out necessarily with hemodialysis. It is important to adequately treat pyelonephritis, which is causing the progression of kidney failure. With secondary nephrocalcinosis, it is important to identify and cure the underlying disease, which is an etiological factor.

Forecast with effective treatment at the onset of the disease, good. Poor prognosis in patients with progressive nephrocalcinosis, because in advanced cases uremia occurs, which threatens the patient's health and life.

Prevention of nephrocalcinosis:

You should get the optimal amount of calcium (no more and no less) with your daily diet.
You can not take calcium supplements without a doctor's prescription.
It is important to treat kidney disease on time.
If suspicious symptoms and any health problems appear, you should urgently consult a general practitioner, family or highly specialized doctor.

Which doctors should you contact if you have nephrocalcinosis:

Nephrologist

Are you worried about something? Do you want to know more detailed information about Nephrocalcinosis, its causes, symptoms, methods of treatment and prevention, the course of the disease and diet after it? Or do you need an inspection? You can make an appointment with the doctor- clinic Eurolab always at your service! The best doctors will examine you, study the external signs and help identify the disease by symptoms, advise you and provide the necessary assistance and diagnose. you also can call a doctor at home... Clinic Eurolab open for you around the clock.

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Other diseases from the group Diseases of the genitourinary system:

"Sharp abdomen" in gynecology

Algodismenorrhea (dysmenorrhea)

Algodismenorrhea secondary

Amenorrhea

Amenorrhea of the pituitary genesis

Amyloidosis of the kidneys

Ovarian apoplexy

Bacterial vaginosis

Infertility

Vaginal candidiasis

Ectopic pregnancy

Intrauterine septum

Intrauterine synechiae (adhesions)

Inflammatory diseases of the genital organs in women

Secondary renal amyloidosis

Secondary acute pyelonephritis

Genital fistula

Genital herpes

Genital tuberculosis

Hepatorenal syndrome

Germ cell tumors

Endometrial hyperplastic processes

Gonorrhea

Diabetic glomerulosclerosis

Dysfunctional uterine bleeding

Dysfunctional uterine bleeding of the perimenopausal period

Diseases of the cervix

Delayed sexual development in girls

Foreign bodies in the uterus

Interstitial nephritis

Vaginal candidiasis

Corpus luteum cyst

Intestinal fistulas of inflammatory genesis

Colpitis

Myeloma nephropathy

Myoma of the uterus

Genitourinary fistula

Disorders of the sexual development of girls

Hereditary nephropathy

Urinary incontinence in women

Myomatous node necrosis

Incorrect positions of the genitals

Nephropathy of pregnancy

Nephrotic syndrome

Primary and secondary nephrotic syndrome

Aggravated urological diseases

Oliguria and anuria

Tumor-like formations of the uterine appendages

Tumors and tumor-like formations of the ovaries

Sex cord stromal tumors (hormone-active)

Prolapse and prolapse (prolapse) of the uterus and vagina

Acute renal failure

Acute glomerulonephritis

Acute glomerulonephritis (AHN)

Acute diffuse glomerulonephritis

Acute nephritic syndrome

Acute pyelonephritis

Lack of sexual development in girls

Focal jade

Paraovarian cysts

Torsion of the legs of tumors of the uterine appendages

Testicular torsion

Nephrocalcinosis is a variant of metastatic calcification, in which calcium salts are diffusely deposited in the kidney tissue, which causes their inflammatory-sclerotic changes, etc.

Types of nephrocalcinosis by clinical manifestations:

primary
secondary

What provokes / Causes of nephrocalcinosis:

Among the causes of primary nephrocalcinosis are:

conditions in which too much calcium enters the body (familial and idiopathic hypercalcemia of newborns, Burnett's syndrome, Lightwood-Fanconi syndrome, sarcoidosis, excessive intravenous calcium salts)
conditions in which calcium is mobilized from bones (tumors of bones and some organs, myeloma, metastases of tumors in the bone, post-castration and corticosteroid osteoporosis, postmenopausal osteoporosis, multiple bone fractures, Paget's disease, neuroplegia, immobilization, thyrotoxicosis)
hypophosphatasia (calcium binding in bones is impaired)
oxalosis, calciphylaxis, in which the unnecessary calcium is deposited in the tissues
tubulopathy and various diseases that occur with acidosis (Buttler-Albright chronic tubular acidosis, Lightwood transient tubular acidosis, Lowe's oculocereborenal syndrome, de Toni-Debreu-Fanconi's glucose-phosphate-aminoaciduria, hyperchloremic acidosis)

Secondary nephrocalcinosis: causes

Among the most likely reasons are:

radiation nephrosclerosis
ischemic cortical renal necrosis
abuse of sulfonamides, thiazide diuretics, phenacetin, ethacrine diuretics, anthranil diuretics
uncontrolled use
poisoning with mercury salts

Pathogenesis (what happens?) During nephrocalcinosis:

Pathogenesis of calcifications

Pathogenesis of nephrocalcinosis

An abnormally large influx of calcium occurs to the kidneys; it accumulates in the epithelial cells of the human kidneys. When too much intracellular calcium is collected, the phenomena of cell degeneration occur. The deposited calcium enters the interstitial space or the lumen of the tubules. In this process, cylinders are formed that overlap the tubules, therefore, they dilate and atrophy. Salt deposits in the interstitium cause a lymphoproliferative reaction, then it occurs.

Symptoms of Nephrocalcinosis:

fatigue
general weakness
vomit
dry skin
thirst
constipation
joint deformity
joint pain
mental instability
keratoconjunctivitis
seizures
shortening the duration of systole on the electrocardiogram

With kidney damage, when the transport of substances in the tubules is disrupted and their sensitivity to antidiuretic hormone is lost, there are:

isostenuria
polyuria
attacks of renal colic are likely (with the discharge of calculi)
lower back pain

Often there are persistent changes in the urinary sediment, it contains a large number of bacteria, leukocytes, salt casts and erythrocytes. Edema and arterial hypertension are later recorded. In this period, as a rule, symptomatic and laboratory signs of kidney failure appear.

Complications:

Chronic renal failure
Obstructive uropathy
Stones in the kidneys

Diagnostics of the nephrocalcinosis:

When diagnosed, nephrocalcinosis is distinguished from the spongy kidney, in which the cystic spaces are filled with condensate of calcium salts.

Treatment of Nephrocalcinosis:

Prevention of nephrocalcinosis:

You should get the optimal amount of calcium (no more and no less) with your daily diet.
You can not take calcium supplements without a doctor's prescription.
It is important to heal on time.
If suspicious symptoms and any health problems appear, you should urgently consult a general practitioner, family or highly specialized doctor.

Which doctors should you contact if you have nephrocalcinosis:

Nephrologist

(+38 044) 206-20-00

If you want to ask a question to the doctor, use the section of the online consultation, perhaps you will find answers to your questions there and read self-care tips... If you are interested in reviews of clinics and doctors, try to find the information you need in the section. Also register on the medical portal Eurolab to keep abreast of the latest news and information updates on the site, which will be automatically sent to your mail.

Other diseases from the group Diseases of the genitourinary system:

"Sharp abdomen" in gynecology

Algodismenorrhea (dysmenorrhea)

Algodismenorrhea secondary

Amenorrhea

Amenorrhea of the pituitary genesis

Amyloidosis of the kidneys

Ovarian apoplexy

Bacterial vaginosis

Infertility

Vaginal candidiasis

Ectopic pregnancy

Intrauterine septum

Intrauterine synechiae (adhesions)

Inflammatory diseases of the genital organs in women

Secondary renal amyloidosis

Secondary acute pyelonephritis

Genital fistula

Genital herpes

Genital tuberculosis

Hepatorenal syndrome

Germ cell tumors

Endometrial hyperplastic processes

Gonorrhea

Diabetic glomerulosclerosis

Dysfunctional uterine bleeding

Dysfunctional uterine bleeding of the perimenopausal period

Diseases of the cervix

Delayed sexual development in girls

Foreign bodies in the uterus

Interstitial nephritis

Vaginal candidiasis

Corpus luteum cyst

Intestinal fistulas of inflammatory genesis

Colpitis

Myeloma nephropathy

Myoma of the uterus

Genitourinary fistula

Disorders of the sexual development of girls

Hereditary nephropathy

Urinary incontinence in women

Myomatous node necrosis

Incorrect positions of the genitals

Nephropathy of pregnancy

Nephrotic syndrome

Primary and secondary nephrotic syndrome

Aggravated urological diseases

Oliguria and anuria

Tumor-like formations of the uterine appendages

Tumors and tumor-like formations of the ovaries

Sex cord stromal tumors (hormone-active)

Prolapse and prolapse (prolapse) of the uterus and vagina

Acute renal failure

Acute glomerulonephritis

Acute glomerulonephritis (AHN)

Acute diffuse glomerulonephritis

Acute nephritic syndrome

Acute pyelonephritis

Lack of sexual development in girls

Focal jade

Paraovarian cysts

Torsion of the legs of tumors of the uterine appendages

Testicular torsion

Nephrocalcinosis or renal calcification is the deposition of calcium salts in the parenchyma of the organ, which is diffuse (widespread) and is accompanied by the development of inflammatory, sclerotic processes in the kidney tissue, which can ultimately lead to chronic renal failure.

Causes of nephrocalcinosis

Depending on the causes of development, there are 2 types of kidney calcification:

primary, which develops in a healthy kidney;
secondary, which affects the pathologically altered organ.

Primary nephrocalcinosis

This is not an independent disease, this pathological condition is a symptom of diseases that are accompanied by disorders of calcium-phosphorus metabolism with the development of hypercalcemia (increased calcium concentration in the blood) and hypercalciuria (active excretion of calcium in the urine). The most common cause of primary renal calcification is:

excessive intake of calcium ions into the body (diet enriched with this element, medications with calcium);
damage to bone tissue with the release of calcium from its depot (bones) into the blood (bone tumors, osteoporosis, bone metastases);
malignant tumors of various localization, which have the ability to synthesize parathyroid hormone;
violation of calcium excretion from the body (hormonal diseases, kidney pathology);
kidney disease, in which the function of the renal tubules, which are responsible for the release of calcium ions into the urine, is impaired (congenital and acquired tubulopathy);
hypervitaminosis D (leads to hypercalcemia and corresponding consequences);
sarcoidosis;
hyperparathyroidism (increased release of parathyroid hormone by the parathyroid glands), in 90% of cases this disease is caused by a hormone-producing tumor of the gland.

Secondary nephrocalcinosis

The reasons that contribute to the development of secondary kidney calcification include:

necrosis of kidney tissue;
violation of blood circulation in the organ (atherosclerosis, thrombosis, embolism of the renal arteries);
radiation damage to the kidneys;
intoxication with mercury compounds;
constant intake of sulfa drugs, phenacetin, thiazide, anthranil, ethacrine diuretics, amphotericin B.

Regulation of calcium metabolism in the body

Normally, calcium metabolism in the body is regulated by 3 hormones: vitamin D, parathyroid hormone and calcitonin. The reservoir of this element is the bones, where calcium is stored, and, if necessary, enters the blood.

Vitamin D enters the body with food and is formed in the skin under the influence of ultraviolet radiation. It increases the concentration of calcium in the blood by:

activation of absorption of calcium from food in the intestine;
increased reabsorption of ions in the kidneys;
enhancing calcium resorption from bones.

Accordingly, with such a pathology as hypervitaminosis D (an excess of vitamin in the body), hypercalcemia with calcification of the kidneys and other organs will develop.

Parathyroid hormone is produced in the parathyroid glands. Its synthesis is regulated by the concentration of calcium in the blood - with a high content of calcium in the blood, the synthesis of parathyroid hormone decreases and vice versa. Parathyroid hormone increases the concentration of calcium in the blood in the following ways:

flushes calcium from bones;
increases the reabsorption of the element in the kidneys;
activates the synthesis of vitamin D;
enhances the absorption of calcium from food in the intestines.

Coming out of the physiological mechanisms of the influence of parathyroid hormone, with an increase in its concentration, hypercalcemia and nephrocalcinosis develop.

Calcitonin is a hormone produced in the thyroid gland. The function of the hormone is to reduce the concentration of calcium in the blood by:

suppression of the process of calcium resorption in bone tissue;
in the kidneys inhibits the reabsorption of ions, which leads to an increase in the excretion of calcium in the urine.

What happens to the kidneys with nephrocalcinosis?

Due to one of the above reasons, the flow of calcium ions to the kidneys increases. The organs cannot cope with the increased load, which leads to the accumulation of calcium inside the cells of the renal parenchyma. When the concentration of calcium inside the epithelial cells that line the renal tubules reaches the border, degenerative processes begin with the death of cells and the deposition of calcium already inside the tubules of the kidneys.

As a result of such pathological processes, calcium cylinders are formed, which completely block the lumen of the tubule, due to which their function is lost. Calcium deposits cause lymphoproliferative reactions, which leads to the proliferation of connective tissue and replacement of the functioning renal parenchyma with useless scar tissue. This leads to nephrosclerosis and kidney wrinkling, kidney failure.

Against the background of changes in the kidneys with nephrocalcinosis, urolithiasis and infections (pyelonephritis) often develop, which further aggravates the situation and leads to complications and progression of organ failure.

Clinical manifestations

As a rule, the clinical picture of this pathology is combined with manifestations of the underlying disease (be it a tumor or hyperparathyroidism), symptoms of hypercalcemia and renal manifestations.

Hypercalcemia symptoms:

general weakness, rapid fatigue, inability to concentrate, drowsiness, depressive states;
skeletal muscle weakness, muscle and joint pain, bone pain;
nausea, vomiting, abdominal pain of a spastic nature, constipation, lack of appetite, pancreatitis;
thirst and dry mouth;
cardiac arrhythmias, pain in the region of the heart, hypertension, during examination, a shortening of the QT interval is found on the ECG, on ultrasound - calcification of the heart valves and blood vessels, with severe hypercalcemia - cardiac arrest;
signs of urolithiasis, frequent pyelonephritis, pain in the lumbar region, signs of progressive renal failure.

When kidney damage is already irreversible, edema, high blood pressure, proteinuria, and other signs of end-stage renal failure appear.

How is the diagnosis made?

It is important! The earlier the diagnosis of nephrocalcinosis is made, the better the chances of saving kidney function. At an early stage of the disease, the only diagnostic method is a puncture biopsy of the kidney, since the changes are not yet visible either on radiography or on ultrasound.

Radiographic signs of nephrocalcinosis appear only in advanced cases, when most of the organ parenchyma is pathologically altered. Ultrasound will also help to suspect calcification, but the scans are very similar to such a congenital pathology as spongy kidney, which requires a differential diagnosis.

In establishing the diagnosis, methods such as determining the concentration of calcium in the blood and urine, the concentration of parathyroid hormone, vitamin D, general and biochemical analysis of blood, urine, examination aimed at finding the root cause of hypercalcemia will also help.

Treatment principles

Treatment of renal calcification, first of all, should be aimed at eliminating the cause of this pathological condition.

In order to correct the level of calcium in the blood, the following are used:

The prognosis for nephrocalcinosis depends on the stage of the disease and the methods of treatment that are used. Most often, at the initial stages of pathology, with timely diagnosis and effective, intensive treatment, the patient's condition improves, kidney function is restored, and the organ can be saved. But with the progression of calcification and the development of renal failure, severe complications are possible, which, if untreated with hemodialysis or kidney transplantation, lead to death.

Nephrocalcinosis is an ailment characterized by an inflammatory process: calcium salts are deposited in the renal tissues. The disease is included in the calcified group of pathologies (called renal dystrophy). The disease begins its development when the metabolic process of calcium in the body is disturbed.

Diluted calcium salts in liquids begin to crystallize and accumulate in the cellular and intercellular space, followed by inflammation and the development of scarring in tissues (sclerosis). This is followed by renal failure. As a rule, renal nephrocalcinosis begins to develop in damaged areas of the kidneys that have suffered from other diseases and / or infections. The disease can develop in both an adult and a newborn child.

Types and pathogenetic aspects of the disease

According to the clinical manifestations of the disease, there are two main forms of renal nephrocalcinosis:

Primary;
Secondary.

With the primary manifestations of nephrocalcinosis, changes in the kidney tissue are not observed (an absolutely healthy organ is affected).

The reasons for the development of the primary form of this disease are:

Vitamin D intoxication or hypervitaminosis;
lactic-alkaline syndrome, which develops with prolonged use of milk and alkaline drugs;
Lightwood-Fanconi disease;
Addison's syndrome;
inflammatory sarcoidosis;
excessive intravenous administration of calcium salts.

Removal of calcium from bone tissue and as a result:

Swelling of bone tissue and internal organs;
disease of the parathyroid glands;
metastatic foci in the bones;
plasmacytoma;
various types of osteoporosis;
bone marrow inflammation (osteomyelitis);
frequent bone fractures;
Paget's disease;
high levels of thyroid hormonal levels.

The secondary form of the disease is accompanied by damage to the damaged organ. Reasons for the secondary form:

Death of nephrons (functional kidney cells) and a decrease in organ size. The cause of death is radiation exposure of the body.
Ischemic necrosis of the renal cortex: rapid necrosis due to acute, insufficient blood supply to the organ.
Long-term and (or) excessive use of antimicrobial (sulfonamides), diuretics (thiazide, ethacrine and anthranilic diuretics) and analgesics (phenacitin).
Uncontrolled intake of the antibiotic amphotericin.
Intoxication with mercury salts.

11 main symptoms and signs of the disease

In the course of this kidney disease, the following symptoms occur:

Rapid fatigability of the human body occurs, endurance decreases;
frequent appearance of weakness in the body;
nausea and vomiting are possible;
signs of dehydration (dizziness and pain, dark circles under the eyes, dark yellow urine, decreased urine output, dry mouth, feeling thirsty);
constipation;
itchy skin;
joint pain is manifested;
seizures;
psychological unstable state of a person;
lack of coordination;
trembling legs and arms.

The above symptoms are characteristic of calcium intoxication.

Pain and cramps in the lumbar region;
renal colic appears;
isostenuria (low specific gravity of excreted urine);
polyuria (large excretion of the amount of urine, above 1000 - 1600 ml.);
there is intense thirst.

In a clinical study in urine sediment, a change in its structure will be observed. Most often it is a high content of bacteria, erythrocytes and leukocytes. Then, swelling, high blood pressure will begin to appear, and at this stage, renal failure is detected, which leads to serious complications:

Can turn into a chronic form of renal failure;
manifest an acute form of renal failure;
the appearance of kidney stones (as a consequence of urolithiasis);
obstructive uropathy may occur (urinary fluid will not go out through the urethra, but will go back to the kidneys).

Why is nephrocalcinosis dangerous?

The accumulation of calcium salts, calcification, in the tissues of the kidneys negatively affects the organ - there is a malfunction. But it is also important to know that the effect of the disease will affect other urinary organs. Deposition can also occur in the bladder. A water-salt imbalance occurs. The formation of numerous calcifications may indicate the development of malignant (less often benign) neoplasms.

Features of the development of the disease

The reasons described above increase the flow of calcium to the organs. The kidneys cannot cope with the increased load, and calcium elements begin to accumulate in the cells of the kidney tissue. The concentration of calcium in kidney cells goes beyond the permissible limits, inflammatory phenomena are triggered, which will lead to further death of organ cells. Dystrophy occurs at the cellular level. Calcium begins to be deposited in the renal tubules themselves.

As a result of such a pathological change in the organ, the so-called calcium cylinders are formed. The tubules become clogged and no longer perform their function in the kidneys. Due to calcium deposits, the connective tissue of the kidneys increases and grows. The parenchyma (the name of the kidney tissue) ceases to maintain the required balance of fluids and electrolytes and is replaced by unnecessary scar tissue (development of sclerosis). Calcifications are formed.

Most often, their formation begins to manifest itself in areas of accumulation of fluids and substances unnecessary to the body. Then signs of nephrocalcinosis appear. The kidneys begin to shrink and shrink. Further, the process leads to the emergence of renal failure. The disease can often be accompanied by urolithiasis and pyelonephritis (kidney infections). This worsens the disease even more and gives the development of serious complications, with the subsequent progression of renal failure.

Diagnostics

If signs of nephrocalcinosis disease are detected, it is necessary to contact a therapist (if the child is a pediatrician) and a nephrologist.

Most often, at the initial stages of the diagnosis of nephrocalcinosis, the patient's blood and urine are submitted for examination. After collecting tests, identifying symptoms, possible causes and examining the patient, the following diagnostic stage is used to confirm the diagnosis, at which the doctor uses instrumental studies of the disease:

Ultrasound procedure;
plain radiography;
magnetic resonance imaging (MRI);
computed tomography (CT);
biopsy.

Ultrasound of the kidneys may not be an effective diagnostic method: deposits can be very small and not always detectable. A more accurate and detailed picture is given by MRI and CT. Biopsy is used in extreme cases, if the previous methods do not give an accurate picture of the course of the disease.

Prevention and treatment basics

Therapeutic treatment of nephrocalcinosis begins with a decrease in calcium in the patient's blood. At the initial stage of the development of the disease, it is enough to introduce the correct diet and adjust your lifestyle. In more advanced cases, they definitely require serious treatment.

The doctor may prescribe treatment with the following medications:

citrate and sodium bicarbonate (they will more effectively remove unnecessary substances from the body);
sodium chloride (helps balance the alkaline environment);
potassium citrate (helps balance the acidic environment);
vitamin B.

When treating nephrocalcinosis, the diet should be aimed at reducing vitamin D, excluding the use of dairy products, sesame and sunflower seeds, almonds, walnuts, halva, legumes, wheat flour baked goods, black bread. But you need to eat foods rich in magnesium. Be sure to drink the highest quality water.

It is necessary to start leading a more active and healthy lifestyle, to engage in physical exercises, this will positively affect the outflow of urine and reduce the concentration of harmful substances.