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Principles of the treatment and diagnosis of renal calcinosis

Renal calcinosis - a diffuse deposition of calcium salts in kidney tissue, accompanied by growth of connective tissue, inflammation and renal insufficiency. The pathogenesis of the disease There are two types of kidney calcification: primar...

Principles of the treatment and diagnosis of renal calcinosis

Aug 19, 2017 by Kidney Disease Expert


Renal calcinosis - a diffuse deposition of calcium salts in kidney tissue, accompanied by growth of connective tissue, inflammation and renal insufficiency.

The pathogenesis of the disease

There are two types of kidney calcification:

  • primary (development of pathological process in previously healthy kidney tissue);
  • secondary (already defeated necrotic tissue).

Primary nephrocalcinosis (nephro - Kidney; calcinosis - deposition of calcium salts) develops due to disturbances of calcium metabolism-phosphate. kidney calcification may sporting due to congenital or acquired renal diseases, in which the basic operation of the tubules (various kinds tubolopatii).

Most often this type of pathology occurs when vitamin D hypervitaminosis, osteoporosis, tsistanoze and hyperparathyroidism.

Secondary nephrocalcinosis developing ischemic necrosis, renal sclerosis, poisoning mercury salts, Amphotericin B and used diuretics ethacrynic. Also contributes to the development of secondary calcification disorder of acid-base balance.

A large number of incoming calcium accumulates in the kidneys of renal epithelial cells. When a certain amount of the substance is exceeded, comes cell degeneration and in this period the calcium begins to move in the lumen of the tubules or interstitial space. The resulting cylinders obscure the lumen of the tubules, thus contributing to the development of atrophy and dilatation. This process is accompanied by a further development of sclerosis or kidney stone formation.

In primary nephrocalcinosis Calcium is primarily deposited in the proximal part of nephron. With further development of the disease it can be deposited in the distal and glomeruli. But the secondary nephrocalcinosis Calcium is deposited simultaneously in all parts of the nephron.

Symptomatology and clinical presentation

In most cases, nephrocalcinosis patients complain of general malaise, weakness, fatigue, itching, joint pain, frequent constipation, seizures, and mental disturbances.

 During examination of the patient and assess the survey results the doctor can detect various types of changes:

  • shortening the duration of systole on the ECG;
  • polyuria, izostenuriyu, polydipsia;
  • pain in the lumbar region during palpation;
  • urolithiasis;
  • proteinuria;
  • limb swelling;
  • hypertension;
  • renal failure.

Diagnostics

Diagnosis of renal calcification is carried out primarily with the inspection and debriefing the patient. For more accurate diagnosis the patient must pass the necessary tests and x-rays to pass.

It is important! At an early stage of development of nephrocalcinosis an accurate diagnosis is made on the basis of taken puncture renal biopsy . Kidney biopsy - this is the most efficient diagnostic method to objectively assess the degree of development of the disease, choose the right method of treatment and to avoid side effects.

At advanced stages of localization of calcium accumulated can be detected by X-ray observation of the kidneys.Established diagnosed based on these symptoms:

  • the presence of calcium salts in parenchyma;
  • diffuse intrarenal calcium distribution.

To clarify the causes of this disease is assigned a biochemical urine and blood tests. Through these analyzes determined the presence of calcium and phosphorus, parathyroid hormone in the blood, activity of alkaline phosphatase, urine hydroxyproline excretion and acid-base balance.

Treatment

Treatment of calcification of the kidneys in the first place, should be aimed at addressing the causes of disorders of phosphate of calcium metabolism in the human body.

In the earlier stages of the disease, the treatment could cost only properly corrected diet with a limited amount of calcium and the use of vitamin B.

The leading role in the development of kidney calcification imbalance plays calcium and magnesium.Therefore, for the normalization process of assimilation of these substances, experts prescribe administration of sodium sulfate and magnesium.

At the most difficult stages of the disease hemodialysis or kidney transplant. Hemodialysis - it extrarenal blood purification, which is the efferent methods of extracorporeal detoxification.

In severe dehydration infusion solutions shown hydrogencarbonate or sodium citrate, and when alkalosis - ammonium solution.

The prognosis depends on the stage of the disease and the treatments. In most cases, early in the disease, at an effective treatment, the patient's condition improves and renal function is restored. With the progression of kidney calcification, severe complications and the development of uremia.

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  • renal calcinosis    
  • renal calcium    

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