Nephrocalcinosis is a disease of the kidney
Pathophysiology
1) calcium deposition in renal parenchyma (kidney tissue) 2) results in abnormal renal functioning 3) caused by systemic hypercalcemia (metastatic calcification) or renal injury such as cortical necrosis or infarcts (dystrophic calcification)
Characteristic Test Findings
Radiology – 1) abdominal series shows diffuse renal calcification Laboratory – 2) calciuria
Histology/Gross Pathology
1) varies from microscopic calcium deposits to gross deposition in parenchyma 2) calcification of basement membranes
Associated Conditions
increased incidence in – 1) multiple myeloma 2) sarcoidosis 3) milk-alkali syndrome 4) excess exogenous vitamin D 5) bony metastases 6) hyperparathyroidism 7) renal osteodystrophy 8) hereditary distal renal tubular acidosis 9) medullary sponge kidney disease
Biochemistry
1) impaired urine concentrating ability 2) renal tubular acidosis 3) salt wasting
Tips for USMLE
if patient is a 56 year old man with mulitple myeloma who develops slowly progressive renal failure, think nephrocalcinosis or renal amyloidosis
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