What Is Medullary Nephrocalcinosis?
Medullary Nephrocalcinosis is a disorder of the kidneys in which there is accumulation of excess calcium within the medulla of the kidney. The medulla of the kidney, also known as renal medulla, is the innermost part of the kidney. It is splint into different parts called pyramids. The function of the renal medulla is to maintain a balance between salt and water in the blood. It also acts as filter for ions such as sodium, chloride, potassium, and calcium.
Medullary Nephrocalcinosis is normally a result of some other medical condition which results in the inability of the renal medulla to filter out the calcium ions causing an accumulation of calcium with the medulla of the kidney causing Medullary Nephrocalcinosis. This condition in itself is normally asymptomatic but the affected individual may experience symptoms of the underlying medical condition that is responsible for the development of Medullary Nephrocalcinosis.
In most of the cases, kidney stones are believed to be responsible for Medullary Nephrocalcinosis and in such cases the affected individual will experience blood in the urine, nausea and vomiting, abdominal pain along with pain in the flank area.
Some of the other causes for Medullary Nephrocalcinosis are certain medication which increases the levels of calcium in the blood, infections, medical conditions like hyperparathyroidism and renal tubular acidosis. In some cases, there has been a genetic link to the development of Medullary Nephrocalcinosis.
The mainstay of treatment for Medullary Nephrocalcinosis is to identify the cause of the condition and then treating it. Preventing further accumulation of calcium within the medulla of the kidney is the primary aim of the treatment of Medullary Nephrocalcinosis.
What Causes Medullary Nephrocalcinosis?
As stated, the main cause for the development of Medullary Nephrocalcinosis is believed to be renal stones, although there are certain infections which also lead to excess calcium in the blood. There are also other medical conditions that are believed to play a part in the development of Medullary Nephrocalcinosis. These medical conditions are:
What Are The Symptoms Of Medullary Nephrocalcinosis?
Medullary Nephrocalcinosis in itself does not cause any symptoms and the symptoms primarily are caused by the medical condition causing Medullary Nephrocalcinosis. The common symptoms that are associated with Medullary Nephrocalcinosis are:
- Blood in the urine
- Fever with chills
- Nausea and vomiting
- Pain in the abdominal and flank regions
How Is Medullary Nephrocalcinosis Diagnosed?
Based on the symptoms described by the patient, the treating physician will order advanced radiological studies in the form of a CT scan of the kidney along with an ultrasound. These studies will clearly show deposition of calcium within the region of the renal medulla confirming the diagnosis of Medullary Nephrocalcinosis.
Some of the other investigations that may be done for diagnosis of Medullary Nephrocalcinosis are blood tests to check for the levels of calcium which will obviously be very high as a result of Medullary Nephrocalcinosis. A urinalysis may also be done to look for presence of red blood cells and crystals for further confirming the diagnosis of Medullary Nephrocalcinosis.
How Is Medullary Nephrocalcinosis Treated?
Preventing further deposition of calcium in the medullary region of the kidney is the primary concern for the treating physician. This will prevent worsening of the condition. The next step towards treatment of Medullary Nephrocalcinosis is to identify the cause of the excess calcium deposits. Once a cause is identified then treatment for that cause is begun immediately to treat Medullary Nephrocalcinosis.
Bringing down the levels of calcium is another challenge for the physician which is done by administration of isotonic sodium chloride which helps in bringing down the levels of calcium in the blood. Potassium and magnesium supplementation along with diuretics and restriction of salt is yet another way to bring down the levels of calcium in the blood and treat Medullary Nephrocalcinosis.
In some cases, with the identification of the cause of Medullary Nephrocalcinosis and prompt treatment, the levels of calcium comes down by themselves thereby treating Medullary Nephrocalcinosis. In some cases where Medullary Nephrocalcinosis is caused by renal tubular acidosis the damage done to the kidneys is basically irreversible.
Thus, it is highly recommended that an individual needs to start immediate treatment once a cause is identified and the diagnosis is confirmed of Medullary Nephrocalcinosis.
Radiopaedia. (2021). Medullary Nephrocalcinosis. https://radiopaedia.org/articles/medullary-nephrocalcinosis
Medscape. (2021). Nephrocalcinosis. https://emedicine.medscape.com/article/244907-overview