There are many causes of distal RTA, which causes may be primary or (more commonly) secondary (due to paraproteinemia, medullary sponge kidney, nephrocalcinosis
, obstructive uropathy, or autoimmune disease, etc.
dTRA is a disease characterised by an unbalanced pH in the body associated with additional disorders such as biochemical impairments that may result in failure to thrive, rickets/osteomalacia, lithiasis and nephrocalcinosis
that can lead to renal failure.
Renal ultrasound revealed bilateral nephrocalcinosis
Metabolic acidosis also leads to nephrocalcinosis
because it causes proximal tubular reabsorption of citrate which results in hypocitraturia that promotes calcium phosphate precipitation.
The predominant underlying disease among the analyzed patients was glomerulonephritis (32%), arterial hypertension (27%), polycystic kidney (11%), diabetes mellitus (8%), other (diabetes mellitus/arterial hypertension, undetermined, lupus, urinary tract infection, nephritis, nephrocalcinosis
, nephrolithiasis, vesicourethral reflux) with 22%.
The usual indications are calculus disease, chronic infections, obstruction, trauma, dysplastic / atrophic kidney or renovascular hypertension due to the renal artery stenosis or severe unilateral parenchymal damage from nephrocalcinosis
, pyelonephritis, reflux or congenital dysplasia.
can complicate high calcium levels and is detected by abdominal ultrasonography.
The majority of patients with Type 1 PH present with recurrent kidney stones and/or nephrocalcinosis
, although onset of symptoms related to stone formation may occur at any age (Cochat et al.
As it has been stressed that hyperthyroidism must be considered in every patient presenting with renal tract stone or nephrocalcinosis
and even in the cases of renal colic.
Thus, nephrolithiasis is present in 42-46% of cases [2, 8], nephrocalcinosis
is present in 30% , and gallstones are present in 35% of cases .
Blood analysis showed a renal injury associated with nephrocalcinosis
diagnosed by ultrasonography and CT scan.
The stage 3 chronic renal disease associated to nephrocalcinosis
might be related to the forearm lipomas, a soft tissue ultrasonography might be useful to assess this condition.