A 38-Year-Old Man With Back and Side Pain: Osmosis USMLE Study Question

February 21, 2020

Nephrocalcinosis is a condition characterized by the calcification of the renal tubules that leads to renal insufficiency. This occurs via metastatic calcification, which means that calcium is deposited in normal tissues, rather than those that have been injured and are degenerating (which is called dystrophic calcification).

Nephrocalcinosis most commonly occurs due to primary hyperparathyroidism, in which the parathyroid glands secrete more parathyroid hormone (PTH) than what is needed to maintain a normal serum calcium level. The most common cause of primary hyperparathyroidism is a parathyroid adenoma, and other causes include parathyroid carcinoma and sporadic parathyroid hyperplasia.

In addition to signs of renal dysfunction, patients may exhibit signs of hypercalcemia, such as constipation, bone pain (due to osteoclasts being indirectly stimulated by PTH to resorb calcium), kidney stones, depression, and seizures. Treatment is via surgically removing the adenoma or parathyroid glands that are responsible.

Major Takeaway: Nephrocalcinosis is a condition characterized by the calcification of the renal tubules that leads to renal insufficiency. It most commonly occurs due to primary hyperparathyroidism, in which the parathyroid glands secrete more PTH than what is needed to maintain a normal serum calcium level.

Read more about hyperparathyroidism.

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