Presentation
Severe renal impairment was present and regressed as the patient improved. The pathogenesis and treatment of vitamin D intoxication is discussed. Received January 22, 1957. Accepted July 25, 1957. [pediatrics.aappublications.org]
At present, more than 80% of patients with primary hyperparathyroidism present with vague constitutional and nonspecific symptoms suggestive of asymptomatic primary hyper parathyroidism. [doi.org]
Radiologic features of nephrocalcinosis are presented in the images below. Radiograph depicting bilateral nephrocalcinosis in an adult male patient who initially presented with features of pancreatitis. Ultimately, hyperparathyroidism was diagnosed. [emedicine.com]
A 65-year-old with multiple myeloma presents with confusion, severe depression, vomiting, constipation, and polyuria. EKG shows shortened QT interval. [medbullets.com]
May rarely present with features of acute kidney injury or chronic kidney disease. [patient.info]
Gastrointestinal
- Polydipsia
There are other pathological entities which give rise to polydipsia and polyuria. [fluoridealert.org]
These include renal colic, polyuria and polydipsia: Renal colic is usually caused by pre-existing nephrolithiasis, as may occur in patients with chronic hypercalciuria. [en.wikipedia.org]
Hypercalcaemia: polyuria and polydipsia, nausea and vomiting. May cause hypertension. [patient.info]
Results There were six girls and three boys with clinical symptoms of polyuria, polydipsia, and less frequently, urinary tract infections and lithiasis. All had hypomagnesemia, hypercalciuria and nephrocalcinosis. [analesdepediatria.org]
Polyuria in sarcoidosis may reflect central diabetes in sipidus (ie, lack of antidiuretic hormone) or primary polydipsia due to granulomatous infiltration of the hypothalamus [27]. [peertechz.com]
Urogenital
- Nocturia
Nocturia, polyuria, and polydipsia from reduced urinary concentrating capacity (i.e. nephrogenic diabetes insipidus) as can be seen in hypercalcemia, medullary nephrocalcinosis of any cause, or in children with Bartter syndrome in whom essential tubular [en.wikipedia.org]
Hx: Look for pre-renal causes: Decreased cardiac output signs & symptoms (lightheadedness,SOB, PND, orthopnea etc) Bleeding GI fluid loss Abnormal polyuria Hx: Obstructive / Post Renal: Nocturia / frequency / hesitancy or decreased urinary stream Dysuria [canadiem.org]
Workup
[…] facial nerve ( Chvostek's Sign ) Symptoms bones fractures stones nephrolithiasis groans anorexia vomiting constipation psychic overtones weakness fatigue altered mental status Evaluation Evaluation EKG may show prolonged QT interval Lab differential workup [medbullets.com]
Albuterol Glucose & insulin Sodium bicarbonate Dialysis IV diuretics B) Bleeding Likely platelet dysfunction secondary to uremia: Desmopressin 0.3-0.4mcg/kg (max dose 20mcg) C) Pulmonary edema IV nitro glycerin and NIPPV Dialysis D) Infection Sepsis workup [canadiem.org]
Ferraro PM, D'Addessi A, Gambaro G: Randall's plaques, plugs and the clinical workup of the renal stone patient. Urolithiasis. 2015; 43 (Suppl 1): 59–61. PubMed Abstract | Publisher Full Text 24. [doi.org]
Treatment
Treatment will involve methods to reduce abnormal levels of calcium, phosphate, and oxalate in the blood and urine. Options include making changes in your diet and taking medicines and supplements. [nlm.nih.gov]
[…] respond satisfactorily when treatment with Vitamin D is stopped [ 3 ]. [link.springer.com]
Treatment consists of correction of the underlying disorder and oral potassium supplements. [merckmanuals.com]
Treatment Hypercalcemic nephropathy: Supportive treatment of the hypercalcemia and treatment of the underlying etiology For the other causes treatment of the underlying cause forms the only possible care Vishal Golay's 37. [slideshare.net]
This clinically oriented reference focuses on diagnosis and treatment of specific diseases, disorders, and complications and incorporates the basic science practicing physicians need to evaluate and manage the disease process. [books.google.de]
Prognosis
Prognosis The prognosis depends mainly on the aetiology of the nephrocalcinosis. [patient.info]
Prognosis for complete recovery of renal function is excellent if treatment is initiated rapidly. In patients with normal cardiac and renal function, treatment is usually with allopurinol plus aggressive IV hydration with normal saline. [merckmanuals.com]
Malignancy-associated hypercalcemia occurs in up to 10% of all patients with advanced cancer and generally conveys a poor prognosis. Indeed, the 30-day mortality rate for cancer patients with hypercalcemia is approximately 50% 2. [jemds.com]
The prognosis of nephrocalcinosis is determined by the underlying cause. [en.wikipedia.org]
Prognosis, therapy and follow-up Prognosis: Although end-stage renal disease (ESRD) requiring some form of renal replacement therapy is uncommon, the sarcoidosis cannot necessarily be considered a benign nephrologic condition. [peertechz.com]
Etiology
Can affect the cortex as well as the medulla depending on the etiology Vishal Golay's 10. [slideshare.net]
Proximal renal tubular acidosis: a not so rare disorder of multiple etiologies. Nephrol. Dial. Transplant. 27, 4273–4287 (2012). Polanco NA, Soto-Abraham MV, Rodríguez-Castellanos FE. [revistas.unc.edu.ar]
Pathogenesis and etiologic factors The etiology and pathophysiology of sarcoidosis has not been fully understood. The noncaseating epithelioid cell granuloma is the principal lesion found in organs affected by sarcoidosis [18]. [peertechz.com]
(includes all NSAIDs, and Aspirin) Direct interstitial nephritis Direct papillary necrosis. 2) Describe the likely pathophysiologic etiology of the following casts Hyaline Casts: Acellular think pre or post renal Red Cell Casts: Glomerular disease (ie [canadiem.org]
Aro Hypomagnesemia due to renal disease of unknown etiology Am J Med, 59 (1975), pp. 873-881 [13.] F. Manz, K. Schärer, P. Janka, J. [analesdepediatria.org]
Epidemiology
Trinchieri A: Epidemiology of urolithiasis: an update. Clin Cases Miner Bone Metab. 2008; 5 (2): 101–6. PubMed Abstract | Free Full Text 2. Curhan GC: Epidemiology of stone disease. Urol Clin North Am. 2007; 34 (3): 287–93. [doi.org]
Epidemiology Microscopic nephrocalcinosis is a common incidental finding at post-mortem but macroscopic nephrocalcinosis is uncommon. [patient.info]
[…] lead to autonomous secretion from individual nodules Therapy with Vitamin D and Ca-based binders These therapies are often associated with hypercalcemia, especially when the extra calcium load is not taken up by bone (such as in adynamic bone disease) Epidemiology [renalandurologynews.com]
This review will summarize the epidemiologic, pathophysiologic, diagnostic, clinical, and therapeutic aspects of RS. [peertechz.com]
Pathophysiology
Each disease-oriented section begins with an up-to-date review of pathophysiology and then focuses on specific diseases. [books.google.de]
Abstract Our purpose here is to test the hypothesis that Randall's plaques, calcium phosphate deposits in kidneys of patients with calcium renal stones, arise in unique anatomical regions of the kidney, their formation conditioned by specific stone-forming pathophysiologies [ncbi.nlm.nih.gov]
While the pathophysiology is plausible, the more likely explanation might be true-true and unrelated. [nephronpower.com]
Hypercalcemia in patients with esophageal carcinoma: The pathophysiologic role of parathyroid hormone-related protein. Cancer 1991; 68(12):2625-29. Stephens RL, Hansen HH, Muggia FM. [jemds.com]
Prevention
Prompt treatment of disorders that lead to nephrocalcinosis, including RTA, may help prevent it from developing. Drinking plenty of water to keep the kidneys flushed and draining will help prevent or decrease stone formation as well. [nlm.nih.gov]
Rapidly find the answers you need with separate sections on diseases and disorders, differential diagnosis, clinical algorithms, laboratory results, and clinical preventive services, plus an at-a-glance format that uses cross-references, outlines, bullets [books.google.com]
Prevention of acute urate nephropathy is indicated for patients at high risk (eg, those at risk of tumor lysis syndrome). [merckmanuals.com]
Medical and Dental Schools 1010 Pharmacological considerations for renal failure and dialysis 1018 Anaesthesia and major surgery in patients with renal failure 1077 Management of the uremic diabetic patient 1107 A Peter Lundin M D 1115 Introduction 1120 Prevention [books.google.de]
The prevention of this type of stone is based on the long-term taking of citrate. [doi.org]