ESPN 51th Annual Meeting

ESPN 2018


 
Diagnostic and therapeutic approach of nephrocalcinosis in children
FERJANI MARYEM 1 HAMMI YOUSRA 1 BOUSETTA ABIR 1 OUALI ASMA 1 JELLOULI MANEL 1 GARGAH TAHAR 1

1- DEPARTMENT OF PEDIATRIC NEPHROLOGY OF CHARLES NICOLLE, TUNIS,TUNISIA
 
Introduction:

 

Nephrocalcinosis is a rare clinical entity that poses major diagnostic and therapeutic problems. The aims of our work are: to establish a correlation between the echographic aspect and the clinical,biological and genetic data, to identify the factors of poor prognosis of evolution towards renal insufficiency and to envisage a prenatal diagnosis in case of a genetically determined disease.

Material and methods:

 

This is a retrospective study of 40 cases of nephrocalcinosis in the pediatric department of Charles Nicolle Hospital in Tunis over a period of 10 years.

Results:

 

The patients were divided into 21 boys and 19 girls with an average age of 3.5 years. The most common mode of revelation was fever in 22.5% of cases followed by pyuria in 17.5% of cases. Physical examination revealed growth retardation in 42.5% of cases. Microscopic hematuria was found in 53.8% of cases. Renal function was impaired in 70% of cases at the time of diagnosis. The diagnosis of nephrocalcinosis was made by renal ultrasound. The following causes were found: primary hyperoxaluria type 1 in 65% of cases, distal tubular acidosis in 20% of cases, hypomagnesemia syndrome with hypercalciuria and nephrocalcinosis in 7% of cases, idiopathic hypercalciuria in 5% cases and Cacchi Ricci disease in one case.End-stage renal failure was noted in 45% of cases, especially in the case of primary hyperoxaluria.

Conclusions:

 

The causes of nephrocalcinosis in children are dominated by primary hyperoxalysis type1. The prognosis is closely related to the underlying pathology and is dominated by progression to chronic renal failure. Precise and early diagnosis is imperative since effective etiopathogenic treatment is possible that can improve or at least stabilize calcium deposits.