Should We Screen Preterm Infants for Nephrocalcinosis? An Evidence-based Decision

Shahirose S Premji; Majeeda Kamaluddeen

Disclosures

Pediatr Health. 2010;4(1):24-35. 

In This Article

Consequences

Long-term prospective studies consistently report spontaneous resolution of nephrocalcinosis over time in premature infants.[20,27–30] In a prospective, observational study, Kaplan–Meier survival analysis, used to estimate the persistence of nephrocalcinosis as a function of time, revealed that when nephrocalcinosis was present at term, the probability that it would persist for at least 15 months was 35% (95% CI: 21–45) and for at least 30 months was 15% (95% CI: 5–25).[20] At a median age of 7 years and at a mean age of 7.5 years (±1 year), 25 and 10% respectively, of premature infants had persistent nephrocalcinosis.[28,29] Classification criteria have also been developed to predict resolution of nephrocalcinosis, but these have differed between studies[1,12] suggesting a different gradation of pathology.[1] Saarela et al. found that classifying nephrocalcinosis as peripheral, scattered or extensive was helpful in predicting ultrasonic resolution at 24 months of age and at 5–6 years of age.[30]

Although some studies report acute consequences of nephrocalcinosis, such as microscopic hematuria,[20] urinary tract infection[3,27,29] or renal colic secondary to ureteric calculus,[27] other studies report no hematuria, proteinuria or urolithiasis,[20,27,28] or no difference in incidence rate of urinary tract infections.[20] Long-term consequences of nephrocalcinosis have been evaluated by studying renal function, biochemistry, kidney growth and blood pressure. Outcome variables have differed between studies; for brevity, salient findings are summarized below.

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