Tubular and interstitial diseases
Reviewers: Nikhil Sangle, M.D. (see Reviewers page)
Revised: 25 December 2012, last major update August 2012
Copyright: (c) 2003-2012, PathologyOutlines.com, Inc.
● Technically, disease of increased renal calcium levels (eMedicine), but usually refers to chronic tubulointerstitial nephropathy of tubular calcium phosphate deposition causing slowly progressive renal insufficiency
● Less common than nephrolithiasis
● Hypercalcemia can also cause glomerular calcium deposition and glomerulosclerosis (Arch Pathol Lab Med 2003;127:E80)
● Hyperphosphaturia and hypercalciuria types differ histologically (Nephrol Dial Transplant 2012;27:1122)
● Endoscopy may be required to distinguish nephrolithiasis (Urol Res 2010;38:421)
● Conditions associated with chronic hypercalcemia, including primary hyperparathyroidism, myeloma or other malignancy; also distal renal tubular acidosis, hypercalciuria due to chronic furosemide use in premature infants (Hum Pathol 2000;31:1363), milk alkali syndrome, oral sodium phosphate as bowel preparation (Hum Pathol 2004;35:675), sarcoidosis, vitamin D intoxication
● Reduce urinary saturation of calcium by increasing fluid intake, crystallization inhibitors, disease-specific medication, (Kidney Int 2011;80:1278)
● Diffuse tubular injury with atrophy, interstitial fibrosis and abundant tubular deposition of calcium phosphate
● Over time, glomerulosclerosis and vascular disease
Grading system: from rat
Electron microscopy images
Calcium deposits (arrows) with glomerular capillary basement membrane and mesangium
End of Kidney non-tumor > Tubular and interstitial diseases > Nephrocalcinosis
Ref Updated: 8/21/12
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