Renal Parenchymal Calcificaton – A Diagnostic Dilema

Introduction: Nephrocalcinosis may be defined as deposition of calacium (in the form of calcium phosphate and calcium oxalate) in the substance of the kidney, a process that can impair the function of the kidney function. The disorder may be symmetric or, in anatomic disorders such as medullary sponge kidney, involve only a single kidney. Nephrocalcinosis is caused by a number of conditions including the excess excretion of calcium by the kidney, renal tubular acidosis, medullary sponge kidney, hypercalcemia, renal cortical necrosis, and tuberculosis. Case Details: A 50-year-old male presented with loin to groin pain for the last 2 months. It was not associated with fever, dysuria or hematuria. He has been suffering from hypertension and dyslipidemia for last 5 years. No other significant past history was found. Multiple USG, X-Ray KUBP, CECT KUB with urogram and Urinary PCR was performed, all of tests revealed same finding of having two calculi in left kidney. The patient complained about having repeated episode of nephrolithiasis in renal colic. Later with detailed study a renal biopsy was performed and findings of left renal parenchymal calcification was confirmed. Conclusion: Patients with medullary nephrocalcinosis may develop nephrolithiasis leading to repeated episodes of renal colic. Treatment of the underlying cause can prevent recurrent renal calculus formation and hence reduce the morbidity associated with the disease.