Nephrocalcinosis in children: A Retrospective Survey

Abstract

Objective: The objectives of this retrospective trial were as follows: Review the clinical aspects of patients (p) with diagnosis of nephrocalcinosis (NC), etiology, renal ultrasonography findings (USR) and laboratory. Evaluate growth and renal function (RF), in relation to the evolution of USR findings, during the follow-up. Analyze if the treatment influences the longitudinal growth and the RF. Material and method: This is an observational, longitudinal and retrospective study in 16 patients with NC, seen in the Nephrology Service of the INSN (Lima), during the period 2011-2012. For statistics analysis, we used the SPSv9 program. Analytical processing was performed by descriptive statistics standard (computerized tabulation, tables and graphs, mean(±ds), for the studied variables.) For the calculation of Z-Score height (HSDS), we used tables of NCHS and WHO (2006 / 7). Results: 69% were girls and 81% were less than 6 years old; 3 of them debuted before one year age; 80% came from Lima. Growth retardation was observed in 81%, hematuria 64%, polyuria 50% and other symptoms were lower percentage. The laboratory analysis confirmed the diagnosis of type I tubular renal acidosis, renal hipercalciuria and intoxication by vitamin D. The NC was medullar in all, being more than 50% grade I, 31% grade II and there were 2 cases (12.5%) with NC grade III. The follow-up of 13 patients was from 0.5 to 14 years and we analyzed the correlation with Z-Score height and observed that there was improvement in the 69%, 5 patients became under -1.88, the majority being NC grade I. Three patients showed no improvement, with grades II and III of NC. In relation to NC and RF, we observed that the patients with NC grade I kept their kidney function. One patient with NC grade III had reached chronic kidney disease stage 2 in its last control. Treatment was in agreement with the etiologic diagnosis (S Shohl: sodium/ potassium citrate, ClK, enalapril, thiazide, amiloride and suspension of vitamin D in the case of poisoning by vitamin D).