Nephrocalcinosis of the kidney: causes, forms, symptoms, diagnosis, treatment, predictions

Many different environmental factors in which humanity lives, provokes the emergence of metabolic shifts in the body. As a result of these disorders, new compounds are formed, which eventually accumulate in certain organs and lead to the development of various diseases. Nephrocalcinosis of the kidneys - what is it?

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

This disease develops often due to a violation of calcium metabolism in the human body for any reason. Salts of calcium crystallize and are deposited in the tissues of organs, mainly in the kidney tissue, developing sclerosis( scarring).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 that are distinguished by etiological factors:

• With the development of sclerosis and deposition of calcium elements on the previously unchanged renal parenchyma, one can speak of the primary form of nephrocalcinosis;
• In the secondary form of the disease, the sediment is fixed on the scar-altered tissues of the kidney. This kind of nephrocalcinosis begins simultaneously with both the cortical part and the tubular epithelium.

By 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 areas of renal pyramids).

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

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

Reasons for

Causative factors for the development of primary nephrocalcinosis:

1. Increased calcium intake in the human body. The cause may be tubulopathy congenital in children, nephropathy of newborns, Burnett syndrome and Lightwood-Fanconia, some other diseases.
2. Pathological conditions in which calcium is strongly excreted from the bones: osteoporosis, hormonal imbalance( hyperparathyroidism), metastatic processes in the osseous system and myeloma, an increase in thyroid hormone levels.
3. Increase in the level of vitamin D in the body, which is responsible for increasing the concentration of calcium in the blood.

Reasons for the development of the secondary form of nephrocalcinosis:

1. Acute disruption of blood supply to the cortical layer of the kidneys.
2. Radiation damage to the kidneys.
3. Toxic effects on the body of mercury.
4. Overdose or use of excessive amounts of phenacetin, sulfonamides.
5. Abuse of various diuretics.
6. Violations associated with changes in acid-base balance of blood.

Signs and Symptoms of

Nephrosclerosis and loss of calcium salts in the kidney 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;
• Heart rate abnormalities, changes in ECG( shortening of the period of cardiac contraction);
• Itching of the skin, dryness and signs of peeling;
• Joints are deformed, painful sensations appear in them when moving;
• The motility of the intestines and stomach is disturbed, which causes painful spasms in the abdomen and constipation.
• Emotional lability;
• There may be signs of hypertension;

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

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

Due to pathological calcification of the renal tubules, their sensitivity to the influence of antidiuretic hormone decreases, resulting in the following symptoms:

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

Diagnosis

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

1. Nephrocalcinosis in the early stages of its development has virtually no clinical manifestations. In the early stages of the disease, the most informative diagnostic method, but also the most invasive, is a kidney biopsy using a puncture technique.
2. Ultrasound examination( US) is considered to be a sufficiently informative method for diagnosing renal calcification in the early stages. On the resulting image, when scanning in different planes and sections, one can see a symptom of perimedullary rings of high echogenicity. Also renal nephrocalcinosis in ultrasound investigation is expressed by the following signs:( with cortical form) linear hyperechoic neoplasms or diffuse nature of inclusion.
3. Radiography and CT are already effective in the late stages of calcification, when triangular pyramids or linear calcifications in the cortical layer of the kidney are clearly visualized in the image.
4. To determine the etiological and pathogenetic conditions of the development of the disease in children and adults, blood and urine are sampled to determine the content of calcium and phosphorus in them.
5. A general analysis of biological fluids( urine and blood), their biochemistry and Sulkovichka's test( the level of calciuria) is carried out.
6. It is very important to assess the functional state of the kidneys, for this purpose, determine the clearance of creatinine, assess the level of alkaline phosphatase.
7. In order to determine the form of the disease( primary or secondary), examine the level of parathyroid hormone in the patient's blood.

On the evidence of early nephrocalcinosis of the kidneys:

Treatment

The treating doctor, having thoroughly studied all the results of the patient's studies, prescribes medication for the purpose of eliminating the root cause of the disease:

• With severe dehydration and acid-base balance, intravenous drip solutionssodium or potassium citrate, potassium aspartate, sodium hydrogencarbonate or sodium chloride).
• If hypercalcemia is not significant, treatment with folk remedies that necessarily include a diet is acceptable.
• Assign the intake of B vitamins, orally or in injectable form.
• With progression of renal failure or the development of a coma, hemodialysis is performed.
• Intravenously administered with hypercalcemia is a solution of magnesium sulfate or sodium phosphate.
• It is possible to prescribe hormonal drugs( prednisolone or thyrecalcitonin).
• If you have signs of pyelonephritis - treatment appropriate for 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, various kinds of cheeses. You can not use wheat flour, bran, almonds, dairy products, oatmeal.

It is necessary to adhere to the diet number 7, which causes the removal of toxins from the body.

Good effect( anti-inflammatory and diuretic effect) have berries of gooseberry, viburnum and sea-buckthorn.

Cooked broth for warm sessile baths from birch and sage leaves improves blood circulation in the vascular bed of the kidneys, removes inflammation.

Forecast

With progression of kidney nephrocalcinosis, the outlook 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 regarding the development of the disease is more favorable. It is impossible to be cured of nephrocalcinosis by folk remedies, so it is very important to consult a doctor in time.