Patients history signs and symptoms
34 year old female
Presents with RUQ pain attention
to the gallbaldder
Diagnosis
 The kindey is markedly abnormal in its
appearance with echogenic pyramids and somewhat
thin cortices. The above findings suggest underlying
nephrocalcinosis.
Normal kidney anatomy
 The normal adult kidney is between 9-12cm long, 2.5-
4cm in depth, an 4-6cm in diameter.
 The kidney has several protective layers starting with
the outer layer. The tough fibrous capsule, then a layer
of perirenal fat, then the renal fascia or Gerota’s fascia.
 The kidney is composed of 2 dinstinct areas, the renal
parenchyma and the renal sinus.
About Nephrocalcinosis
 Nephrocalcinosis is a renal parenchymal calcium
deposition, predominatley cortical, medullary, or
involving both regions.
 Usually bilateral and diffuse.
 The most common cause is cortical calcifications
identified in the hypercalcemic states associated with
malignancy, hyperparathyroidism, or vitamin D
intoxication, acute cortical necrosis, chronic
glomerulonephritis, and acquired immune defiency
sydrome, (AIDS) cases associated with MAI.
continued
 The most common cause is a metabolic abnormality
usually identified in hypercalciuria and hypercalcemic
states associated with medullary sponge kidney and
papillary necrosis in situ.
TREATMENT
 The goal of treatment is to reduce the symptoms,
therefore the cause if this disorder must be treated.
 Such as if the cause is TYPE 1, renal tubular acidosis,
vitamin D, and calcium should not be given to correct
bone disorders.
 Other treatment consists of adequate hydration by
isotonic sodium chloride solution, parathyroidectomy,
or calcium-sensing receptor stimulant cinacalcet for
correction of hyperthryroidism.
Bibliography
 Diagnositc Medical Sonography. A guide to clinical
practice. Abdomen and superficial structures. 2nd Ed.
Diane M. Kawamura. Lippincott Williams &
wilkins.1997.
 Google.com.http://emedicine.medscape.com/article/2
43911-treatment.copyright 1994-2009 by medscape.
Page 3.
 Sonography. Intoduction to normal structure and
functions. Reva Arnez Curry, Betty Bates Tempkin..
Saunders. 2nd Ed.copyright 2004.