Nephrocalcinosis

Re-defined in the era of endourology

Nicole L. Miller, Mitchell R. Humphreys, Fredric L. Coe, Andrew Evan, Sharon B. Bledsoe, Shelly E. Handa, James E. Lingeman

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Nephrocalcinosis generally refers to the pres ence of calcium salts within renal tissue, but this term is also used radiologically in diagnostic imaging in disease states that also produce renal stones, so that it is not always clear whether it is tissue calcifications or urinary calculi that give rise to the characteristic appearance of the kidney on x-ray or computed tomography (CT). Recent advances in endoscopic imaging now allow the visual distinction between stones and papillary nephrocalcinosis, and intra-renal endoscopy can also verify the complete removal of urinary stones, so that subsequent radiographic appearance can be confidently attributed to nephrocalcinosis. This report shows exemplary cases of primary hyperparathy roidism, type I distal renal tubular acidosis, medullary sponge kidney, and common calcium oxalate stone for mation. In the first three cases - all being conditions commonly associated with nephrocalcinosis - it is shown that the majority of calcifications seen by radiograph may actually be stones. In common calcium oxalate stones formers, it is shown that Randall's plaque can appear as a small calculus on CT scan, even when calyces are known to be completely clear of stones. In the current era with the use of non-contrast CT for the diagnosis of nephrolithiasis, the finding of calcifications in close association with the renal papillae is common. Distinguishing nephrolithiasis from nephrocalcinosis requires direct visual inspection of the papillae and so the diagnosis of nephrocalcinosis is essentially an endoscopic, not radiologic, diagnosis.

Original languageEnglish
Pages (from-to)421-427
Number of pages7
JournalUrological Research
Volume38
Issue number6
DOIs
StatePublished - Dec 2010

Fingerprint

Nephrocalcinosis
Kidney
Renal Tubular Acidosis
Nephrolithiasis
Calcium Oxalate
Urinary Calculi
Tomography
Medullary Sponge Kidney
Calculi
Diagnostic Imaging
Endoscopy
Salts
X-Rays
Calcium

Keywords

  • Hyperparathyroidism
  • Kidney calculi
  • Medullary sponge
  • Nephrocalcinosis
  • Renal tubular acidosis

ASJC Scopus subject areas

  • Urology

Cite this

Miller, N. L., Humphreys, M. R., Coe, F. L., Evan, A., Bledsoe, S. B., Handa, S. E., & Lingeman, J. E. (2010). Nephrocalcinosis: Re-defined in the era of endourology. Urological Research, 38(6), 421-427. https://doi.org/10.1007/s00240-010-0328-8

Nephrocalcinosis : Re-defined in the era of endourology. / Miller, Nicole L.; Humphreys, Mitchell R.; Coe, Fredric L.; Evan, Andrew; Bledsoe, Sharon B.; Handa, Shelly E.; Lingeman, James E.

In: Urological Research, Vol. 38, No. 6, 12.2010, p. 421-427.

Research output: Contribution to journalArticle

Miller, NL, Humphreys, MR, Coe, FL, Evan, A, Bledsoe, SB, Handa, SE & Lingeman, JE 2010, 'Nephrocalcinosis: Re-defined in the era of endourology', Urological Research, vol. 38, no. 6, pp. 421-427. https://doi.org/10.1007/s00240-010-0328-8
Miller NL, Humphreys MR, Coe FL, Evan A, Bledsoe SB, Handa SE et al. Nephrocalcinosis: Re-defined in the era of endourology. Urological Research. 2010 Dec;38(6):421-427. https://doi.org/10.1007/s00240-010-0328-8
Miller, Nicole L. ; Humphreys, Mitchell R. ; Coe, Fredric L. ; Evan, Andrew ; Bledsoe, Sharon B. ; Handa, Shelly E. ; Lingeman, James E. / Nephrocalcinosis : Re-defined in the era of endourology. In: Urological Research. 2010 ; Vol. 38, No. 6. pp. 421-427.
@article{688aa5d1c456440d8ca172bf1e7d83ed,
title = "Nephrocalcinosis: Re-defined in the era of endourology",
abstract = "Nephrocalcinosis generally refers to the pres ence of calcium salts within renal tissue, but this term is also used radiologically in diagnostic imaging in disease states that also produce renal stones, so that it is not always clear whether it is tissue calcifications or urinary calculi that give rise to the characteristic appearance of the kidney on x-ray or computed tomography (CT). Recent advances in endoscopic imaging now allow the visual distinction between stones and papillary nephrocalcinosis, and intra-renal endoscopy can also verify the complete removal of urinary stones, so that subsequent radiographic appearance can be confidently attributed to nephrocalcinosis. This report shows exemplary cases of primary hyperparathy roidism, type I distal renal tubular acidosis, medullary sponge kidney, and common calcium oxalate stone for mation. In the first three cases - all being conditions commonly associated with nephrocalcinosis - it is shown that the majority of calcifications seen by radiograph may actually be stones. In common calcium oxalate stones formers, it is shown that Randall's plaque can appear as a small calculus on CT scan, even when calyces are known to be completely clear of stones. In the current era with the use of non-contrast CT for the diagnosis of nephrolithiasis, the finding of calcifications in close association with the renal papillae is common. Distinguishing nephrolithiasis from nephrocalcinosis requires direct visual inspection of the papillae and so the diagnosis of nephrocalcinosis is essentially an endoscopic, not radiologic, diagnosis.",
keywords = "Hyperparathyroidism, Kidney calculi, Medullary sponge, Nephrocalcinosis, Renal tubular acidosis",
author = "Miller, {Nicole L.} and Humphreys, {Mitchell R.} and Coe, {Fredric L.} and Andrew Evan and Bledsoe, {Sharon B.} and Handa, {Shelly E.} and Lingeman, {James E.}",
year = "2010",
month = "12",
doi = "10.1007/s00240-010-0328-8",
language = "English",
volume = "38",
pages = "421--427",
journal = "Urolithiasis",
issn = "2194-7228",
publisher = "Springer Verlag",
number = "6",

}

TY - JOUR

T1 - Nephrocalcinosis

T2 - Re-defined in the era of endourology

AU - Miller, Nicole L.

AU - Humphreys, Mitchell R.

AU - Coe, Fredric L.

AU - Evan, Andrew

AU - Bledsoe, Sharon B.

AU - Handa, Shelly E.

AU - Lingeman, James E.

PY - 2010/12

Y1 - 2010/12

N2 - Nephrocalcinosis generally refers to the pres ence of calcium salts within renal tissue, but this term is also used radiologically in diagnostic imaging in disease states that also produce renal stones, so that it is not always clear whether it is tissue calcifications or urinary calculi that give rise to the characteristic appearance of the kidney on x-ray or computed tomography (CT). Recent advances in endoscopic imaging now allow the visual distinction between stones and papillary nephrocalcinosis, and intra-renal endoscopy can also verify the complete removal of urinary stones, so that subsequent radiographic appearance can be confidently attributed to nephrocalcinosis. This report shows exemplary cases of primary hyperparathy roidism, type I distal renal tubular acidosis, medullary sponge kidney, and common calcium oxalate stone for mation. In the first three cases - all being conditions commonly associated with nephrocalcinosis - it is shown that the majority of calcifications seen by radiograph may actually be stones. In common calcium oxalate stones formers, it is shown that Randall's plaque can appear as a small calculus on CT scan, even when calyces are known to be completely clear of stones. In the current era with the use of non-contrast CT for the diagnosis of nephrolithiasis, the finding of calcifications in close association with the renal papillae is common. Distinguishing nephrolithiasis from nephrocalcinosis requires direct visual inspection of the papillae and so the diagnosis of nephrocalcinosis is essentially an endoscopic, not radiologic, diagnosis.

AB - Nephrocalcinosis generally refers to the pres ence of calcium salts within renal tissue, but this term is also used radiologically in diagnostic imaging in disease states that also produce renal stones, so that it is not always clear whether it is tissue calcifications or urinary calculi that give rise to the characteristic appearance of the kidney on x-ray or computed tomography (CT). Recent advances in endoscopic imaging now allow the visual distinction between stones and papillary nephrocalcinosis, and intra-renal endoscopy can also verify the complete removal of urinary stones, so that subsequent radiographic appearance can be confidently attributed to nephrocalcinosis. This report shows exemplary cases of primary hyperparathy roidism, type I distal renal tubular acidosis, medullary sponge kidney, and common calcium oxalate stone for mation. In the first three cases - all being conditions commonly associated with nephrocalcinosis - it is shown that the majority of calcifications seen by radiograph may actually be stones. In common calcium oxalate stones formers, it is shown that Randall's plaque can appear as a small calculus on CT scan, even when calyces are known to be completely clear of stones. In the current era with the use of non-contrast CT for the diagnosis of nephrolithiasis, the finding of calcifications in close association with the renal papillae is common. Distinguishing nephrolithiasis from nephrocalcinosis requires direct visual inspection of the papillae and so the diagnosis of nephrocalcinosis is essentially an endoscopic, not radiologic, diagnosis.

KW - Hyperparathyroidism

KW - Kidney calculi

KW - Medullary sponge

KW - Nephrocalcinosis

KW - Renal tubular acidosis

UR - http://www.scopus.com/inward/record.url?scp=78651308491&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=78651308491&partnerID=8YFLogxK

U2 - 10.1007/s00240-010-0328-8

DO - 10.1007/s00240-010-0328-8

M3 - Article

VL - 38

SP - 421

EP - 427

JO - Urolithiasis

JF - Urolithiasis

SN - 2194-7228

IS - 6

ER -