Etiology of nephrocalcinosis in northern Indian children.
This retrospective survey examines the etiology of nephrocalcinosis (NC) in 40 patients (26 boys), over an 8-year period. The median age at onset of symptoms and presentation was 36 months and 72 months, respectively. Clinical features included marked failure to thrive (82.5%), polyuria (60%) and bony deformities (52.5%). The etiology of NC included distal renal tubular acidosis (RTA) in 50% patients and idiopathic hypercalciuria and hyperoxaluria in 7.5% each. Other causes were Bartter syndrome, primary hypomagnesemia with hypercalciuria, severe hypothyroidism and vitamin D excess. No cause for NC was found in 12.5% patients. Specific therapy, where possible, ameliorated the biochemical aberrations, although the extent of NC remained unchanged. At a median (range) follow up of 35 (14-240) months, glomerular filtration rate (GFR) had declined from 82.0 (42-114) ml/min per 1.73 m2 body surface area to 70.8 (21.3-126.5) ml/min per 1.73 m2 body surface area (P = 0.001). Our findings confirm that, even with limited diagnostic facilities, protocol-based evaluation permits determination of the etiology of NC in most patients.
Mantan
Mukta
M
Department of Pediatrics, Maulana Azad Medical College and Associated Hospitals, New Delhi, India.
Bagga
Arvind
A
Virdi
Virenderjeet Singh
VS
Menon
Shina
S
Hari
Pankaj
P
D000141:Acidosis, Renal Tubular / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology; D000293:Adolescent; D001477:Bartter Syndrome / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology; D001847:Bone Diseases / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D005183:Failure to Thrive / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D053565:Hypercalciuria / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology; D006959:Hyperoxaluria / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology; D007194:India / Q000453:epidemiology; D007223:Infant; D008297:Male; D009397:Nephrocalcinosis / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D011141:Polyuria / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology; D012189:Retrospective Studies; D014807:Vitamin D / Q000009:adverse effects
D014807:Vitamin D