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]
Cardiovascular
- Hypertension
The patient exhibited hypertensive encephalopathy. The management of severe hypertension in this case is discussed in detail. Severe renal impairment was present and regressed as the patient improved. [pediatrics.aappublications.org]
Distribution of gene polymorphisms of rennin - angiotensin system between iga nephropathy with hypertension and asymptomatic abnormal urinalysis subtype 腎病高血壓型和尿檢異常型中的分佈 Observations on curative effect of diabetic nephropathy at azotemic stage treated [dict.site]
Besides renal insufficiency and frank renal failure, nephrotic syndrome, nephrolithiasis, hypertension, and a variety of tubular defects may complicate sarcoidosis. [ncbi.nlm.nih.gov]
Catabolic state, protein loads Nephrotoxic agents Obstructive disease Reflux disease Treatable Causes Renal artery stenosis Malignant hypertension Acute interstitial nephritis Hypercalcemic nephropathy Multiple myeloma Vasculitis Obstructive nephropathy [canadiem.org]
The remaining twelve sections cover various types of diseases, including hypertension, urological problems, and urinary tract concerns. [books.google.de]
Neurologic
- Encephalopathy
KEYWORDS: Hypercalcemia, esophagus, leiomyosarcoma, encephalopathy. Nandiniswamy, Ravikumar, Sanjeev, Anil, Sai Shruthi. A Rare Case of Hypercalcemic Encephalopathy in a Case of Carcinoma Esophagus with Coexisting Leiomyosarcoma of Stomach. [jemds.com]
The patient exhibited hypertensive encephalopathy. The management of severe hypertension in this case is discussed in detail. Severe renal impairment was present and regressed as the patient improved. [pediatrics.aappublications.org]
[…] impairment with growth failure Renal tubular acidosis Renal tubular acidosis with progressive nerve deafness Renal tubular disorder San Francisco RTA syndrome Tertiary hyperparathyroidism Transient neonatal renal tubular acidosis Uremic acidosis Uremic encephalopathy [emedcodes.com]
Renal tubular acidosis Renal tubular acidosis type 4 Renal tubular acidosis with progressive nerve deafness Renal tubular disorder San Francisco RTA syndrome Tertiary hyperparathyroidism Transient neonatal renal tubular acidosis Uremic acidosis Uremic encephalopathy [icd9data.com]
[…] causes of altered mental status in dialysis patients Box 87.11 Structural Conditions Cerebrovascular accident Subdural hematoma Intracerebral abscess Brain tumor Metabolic Conditions Disequilibrium syndrome Uremia Drug effects Meningitis Hypertensive encephalopathy [canadiem.org]
Urogenital
- Renal Insufficiency
nephritic syndrome; pyelonephritis; renal insufficiency R25 Prostatitis Prostatitis/BPH R27 Renal calculi — drainage remedy Urinary calculi-bladder/renal calculi; glomerulonephritis; hydronephrosis; renal colic GENITOURINARY REMEDIES INDICATIONS R34 [unitedremedies.com]
Severe ( > 12 mg/dL) temporary hypercalcemia may cause reversible renal insufficiency by renal vasoconstriction and natriuresis-induced volume depletion. [merckmanuals.com]
NOS Renal disease (acute) NOS Renal insufficiency (acute) Type 1 Excludes chronic renal insufficiency ( N18.9 ) unspecified nephritic syndrome ( N05.- ) hypercalcemic N25.89 hypokalemic N25.89 (vacuolar) potassium depletion N25.89 protein-losing N25.89 [icd10data.com]
Besides renal insufficiency and frank renal failure, nephrotic syndrome, nephrolithiasis, hypertension, and a variety of tubular defects may complicate sarcoidosis. [ncbi.nlm.nih.gov]
- Renal Function Impairment
The ICD 9 Code for Other specified disorders resulting from impaired renal function is listed as 588.89. [emedcodes.com]
2012 ICD-9-CM Diagnosis Code 588.89 Other specified disorders resulting from impaired renal function Short description: Impair ren funct dis NEC. [icd9data.com]
function, impaired N25.9 ICD-10-CM Diagnosis Code N25.9 Disorder resulting from impaired renal tubular function, unspecified 2016 2017 2018 2019 Billable/Specific Code specified NEC N25.89 Impaired, impairment (function) kidney N28.9 ICD-10-CM Diagnosis [icd10data.com]
- 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]
Early treatment of reversible causes of renal failure, such as treatment of urinary infections, calculous obstruction and hypertension, is essential. Once renal failure is established, it must be treated accordingly. [patient.info]
Prognosis
The prognosis depends upon the extension of calcic deposit and, above all, on the feasibility, by treating the causal disease, of preventing the calcification process. [infona.pl]
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]
Etiology
The etiologies of the NC are transcribed in Table 1. Table 1: Clinical manifestations in children with nephrocalcinosis. Table 2 : Etiologies of nephrocalcinosis. [latunisiemedicale.com]
Les etiologies en sont multiples, mais impliquent presque toutes un trouble metabolique, souvent d'origine genetique, parfois iatrogene, augmentant l'excretion urinaire du calcium ou de l'oxalate. [infona.pl]
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]
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]
Epidemiology of primary hyperoxaluria type 1. Nephrol Dial Transplant 1995;10:3-7. Harambat J, Fargue S, Acquaviva C et al. [latunisiemedicale.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]