Renal calcification: treatment and diagnosis of the disease

Renal calcification is the diffuse deposition of calcium salts in kidney tissue, accompanied by proliferation of connective tissue, inflammatory process and renal insufficiency.

Pathogenesis of the disease

There are two types of calcification of the kidneys:

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

Primary nephrocalcinosis( nephro-kidney, calcification - deposition of calcium salts) develops as a result of a disruption of the phosphate-calcium metabolism. Calcification of the kidneys can frolic due to congenital or acquired kidney diseases, in which the main work of tubules( various kinds of tubulopathy) is disrupted.

Most often this type of pathology occurs in hypervitaminosis of vitamin D, osteoporosis, cystanol and hyperparathyroidism.

Secondary nephrocalcinosis develops with ischemic necrosis, sclerosis of the kidneys, poisoning with mercury salts, use of amphotericin B and ethacrylic diuretics. Also, the development of secondary calcification is promoted by the violation of acid-base balance.

A large amount of calcium supplied to the kidneys accumulates in the cells of the renal epithelium. When a certain amount of this substance is exceeded, there is a degeneration of cells and this during the period of calcium begins to move into the lumen of the tubules or the interstitial space. Formed cylinders obscure the lumen of the tubules, thereby contributing to the development of atrophy and dilatation. Such a process in the future is accompanied by the development of sclerosis of the kidneys or stone formation.

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

Symptomatic and clinical picture of

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

During the examination of the patient and evaluation of the results of the examination the doctor can detect various kinds of changes:

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

Diagnosis

Diagnosis of kidney calcification is carried out, first of all, with the examination and questioning of the patient. To clarify the diagnosis, the patient needs to pass the necessary tests and undergo an X-ray examination.

This is important! At an early stage of nephrocalcinosis, an accurate diagnosis is made based on the kidney puncture biopsy taken. A kidney biopsy is the most rational method of diagnosis, allowing you to objectively assess the degree of development of pathology, choose the right method of treatment and avoid side effects.

In advanced stages, the localization of accumulated calcium can be detected using renal radiography. The established diagnosis is based on such signs:

• presence of calcium salt in the parenchyma;
• diffuse intrarenal calcium spread.

To determine the cause of this pathology, biochemical analysis of urine and blood is prescribed. With the help of these analyzes, the presence of calcium and phosphorus, parathyroid hormone in the blood, the activity of alkaline phosphatase, the release of hydroxyproline in the urine and acid-base balance are determined.

Treatment of

Treatment of calcification of kidneys in the first place, should be aimed at eliminating the cause of the disruption of phosphate-calcium metabolism in the human body.

In the earlier stages of the disease, treatment can only manage a properly adjusted diet with a limited amount of calcium and vitamin B.

The leading role in the development of calcification of the kidneys is a violation of the balance of calcium and magnesium. Therefore, to normalize the process of assimilation of these substances, specialists prescribe the introduction of a solution of sodium and magnesium sulfate.

In the most severe stages of the disease, hemodialysis or kidney transplantation is performed. Hemodialysis is an extrarenal blood purification, which is an efferent method of extracorporeal detoxification of the body.

In severe form of dehydration, infusions of solutions of bicarbonate or sodium citrate are shown, and for alkalosis, ammonium solution is indicated.

The prognosis depends on the stage of the disease and the treatment methods. Most often, at the very beginning of the disease, with effective treatment, the patient's condition improves, and the functional state of the kidneys is restored. With the progression of calcification of the kidneys, serious complications and the development of uremia are possible.

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