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Microscopic nephrocalcinosis and hypercalciuria in nephrotic syndrome
H Mocan1, A Yildiran, T Camlibel
1Department of Paediatrics, American Hospital, Istanbul, Turkey.
Human Pathology
|December 9, 2000
Summary
Children with nephrotic syndrome on furosemide may develop transient hypercalciuria and kidney calcifications. Monitoring urinary calcium and pH is crucial, particularly in those unresponsive to steroids.
Area of Science:
- Nephrology
- Pediatric Nephrology
- Renal Pathology
Background:
- Focal calcification is an uncommon tubular abnormality in minimal-change nephrotic syndrome.
- Nephrocalcinosis has been documented in premature infants due to hypercalciuria from long-term furosemide treatment.
Purpose of the Study:
- To describe cases of nephrotic children experiencing transient hypercalciuria and intraluminal renal calcifications.
- To highlight the potential risk of nephrocalcinosis in nephrotic syndrome patients undergoing furosemide therapy.
Main Methods:
- Case series involving 4 nephrotic children (3 minimal change, 1 diffuse proliferative glomerulonephritis).
- Analysis of renal histopathological specimens for intraluminal calcifications.
- Clinical data review including therapy (furosemide, albumin, corticosteroids) and urinary infections.
Main Results:
- Four nephrotic children presented with transient hypercalciuria and intraluminal calcifications on renal biopsy.
- These calcifications were not detected radiologically.
- All patients were resistant to corticosteroid therapy and received furosemide for edema management; two had concurrent urinary infections.
Conclusions:
- Children with nephrotic syndrome are at risk for developing nephrocalcinosis.
- Close monitoring of urinary calcium and pH is recommended during prolonged furosemide use.
- Particular vigilance is advised for nephrotic patients with initial poor response to corticosteroids.