Top

Published in:

Open Access 01-02-2010 | Educational Review

Nephrocalcinosis in preterm neonates

Authors: Eveline A. Schell-Feith, Joana E. Kist-van Holthe, Albert J. van der Heijden

Published in: Pediatric Nephrology | Issue 2/2010

Abstract

The prevalence of nephrocalcinosis (NC) in preterm neonates in recent reports is 7–41%. The wide range in prevalence is a consequence of different study populations and ultrasound equipment and criteria, in addition to a moderate interobserver variation. NC in preterm neonates has a multifactorial aetiology, consisting of low gestational age and birth weight, often in combination with severe respiratory disease, and occurs as a result of an imbalance between stone-promoting and stone-inhibiting factors. A limited number of histological studies suggest that calcium oxalate crystals play an important role in NC in premature neonates. In 85% of children resolution of NC occurs in the first years of life. Prematurity, per se, is associated with high blood pressure, relatively small kidneys, and (distal) tubular dysfunction. In addition, NC in preterm neonates can have long-term sequelae for glomerular and tubular function. Long-term follow-up of blood pressure and renal function of prematurely born children, especially with neonatal NC, is recommended. Prevention of NC with (low) oral doses of citrate has not resulted in a significant decrease in the prevalence of NC; a higher citrate dosage deserves further study. Future research pertaining to prevention of NC in preterm neonates is crucial.

Available only for authorised users

Hufnagle KG, Khan SN, Penn D, Cacciarelli A, Williams P (1982) Renal calcifications: a complication of long-term furosemide therapy in preterm infants. Pediatrics 70:360–363PubMed

Chevalier RL (1996) Developmental renal physiology of the low birth weight pre-term newborn. J Urol 156:714–719PubMed

Rodriguez-Soriano J, Aguirre M, Oliveros R, Vallo A (2005) Long-term renal follow-up of extremely low birth weight infants. Pediatr Nephrol 20:579–584PubMed

Barker DJ (1990) The fetal and infant origins of adult disease. BMJ 301:1111PubMedPubMedCentral

Keijzer-Veen MG, Kleinveld HA, Lequin MH, Dekker FW, Nauta J, de Rijke YB, van der Heijden BJ (2007) Renal function and size at young adult age after intrauterine growth restriction and very premature birth. Am J Kidney Dis 50:542–551PubMed

Kistner A, Celsi G, Vanpee M, Jacobson SH (2000) Increased blood pressure but normal renal function in adult women born preterm. Pediatr Nephrol 15:215–220PubMed

Jacinto JS, Modanlou HD, Crade M, Strauss AA, Bosu SK (1988) Renal calcification incidence in very low birth weight infants. Pediatrics 81:31–35PubMed

Short A, Cooke RW (1991) The incidence of renal calcification in preterm infants. Arch Dis Child 66:412–417PubMedPubMedCentral

Sheu JN, Chen CH, Lue KH, Chen JY, Tsau YK, Chen JH (1993) Renal calcification in very low birth weight infants. Am J Nephrol 13:6–11PubMed

10.

Katz ME, Karlowicz MG, Adelman RD, Werner AL, Solhaug MJ (1994) Nephrocalcinosis in very low birth weight neonates: sonographic patterns, histologic characteristics, and clinical risk factors. J Ultrasound Med 13:777–782PubMed

11.

Saarela T, Vaarala A, Lanning P, Koivisto M (1999) Incidence, ultrasonic patterns and resolution of nephrocalcinosis in very low birthweight infants. Acta Paediatr 88:655–660PubMed

12.

Schell-Feith EA, Holscher HC, Zonderland HM, Kist-Van Holthe JE, Conneman N, van Zwieten PH, Brand R, van der Heijden AJ (2000) Ultrasonographic features of nephrocalcinosis in preterm neonates. Br J Radiol 73:1185–1191PubMed

13.

Narendra A, White M, Rolton H, Alloub Z, Wilkinson G, McColl J, Beattie J (2001) Nephrocalcinosis in preterm babies. Arch Dis Child Fetal Neonatal Ed 85:F207–F213PubMedPubMedCentral

14.

Hoppe B, Duran I, Martin A, Kribs A, Benz-Bohm G, Michalk DV, Roth B (2002) Nephrocalcinosis in preterm infants: a single center experience. Pediatr Nephrol 17:264–268PubMed

15.

Hein G, Richter D, Manz F, Weitzel D, Kalhoff H (2004) Development of nephrocalcinosis in very low birth weight infants. Pediatr Nephrol 19:616–620PubMed

16.

Ketkeaw K, Thaithumyanon P, Punnahitananda S (2004) Nephrocalcinosis in very low birth weight infants: a single center experience. J Med Assoc Thai 87 [Suppl 2]:S72–S77

17.

Alon U, Brewer WH, Chan JC (1983) Nephrocalcinosis: detection by ultrasonography. Pediatrics 71:970–973PubMed

18.

Cramer B, Husa L, Pushpanathan C (1998) Nephrocalcinosis in rabbits—correlation of ultrasound, computed tomography, pathology and renal function. Pediatr Radiol 28:9–13PubMed

19.

Dick PT, Shuckett BM, Tang B, Daneman A, Kooh SW (1999) Observer reliability in grading nephrocalcinosis on ultrasound examinations in children. Pediatr Radiol 29:68–72PubMed

20.

Shultz PK, Strife JL, Strife CF, McDaniel JD (1991) Hyperechoic renal medullary pyramids in infants and children. Radiology 181:163–167PubMed

21.

Chiara A, Chirico G, Comelli L, De Vecchi E, Rondini G (1990) Increased renal echogenicity in the neonate. Early Hum Dev 22:29–37PubMed

22.

Herman TE, Siegel MJ (1991) Pyramidal hyperechogenicity in autosomal recessive polycystic kidney disease resembling medullary nephrocalcinosis. Pediatr Radiol 21:270–271PubMed

23.

Riebel TW, Abraham K, Wartner R, Müller R (1993) Transient renal medullary hyperechogenicity in ultrasound studies of neonates: is it a normal phenomenon and what are the causes? J Clin Ultrasound 21:25–31PubMed

24.

Starinsky R, Vardi O, Batasch D, Goldberg M (1995) Increased renal medullary echogenicity in neonates. Pediatr Radiol 25 [Suppl 1]:S43–S45PubMed

25.

Streitman K, Toth A, Horvath I, Tálosi G (2001) Renal injury in perinatal hypoxia: ultrasonography and changes in renal function. Eur J Pediatr 160:473–477PubMed

26.

Makhoul IR, Soudack M, Smolkin T, Sujov P, Epelman M, Eisenstein I, Magen D, Zelikovic I (2005) Neonatal transient renal failure with renal medullary hyperechogenicity: clinical and laboratory features. Pediatr Nephrol 20:904–909PubMed

27.

Downing GJ, Egelhoff JC, Daily DK, Alon U (1991) Furosemide-related renal calcifications in the premature infant. A longitudinal ultrasonographic study. Pediatr Radiol 21:563–565PubMed

28.

Karlowicz MG, Katz ME, Adelman RD, Solhaug MJ (1993) Nephrocalcinosis in very low birth weight neonates: family history of kidney stones and ethnicity as independent risk factors. J Pediatr 122:635–638PubMed

29.

McCormick FC, Brady K, Keen CE (1996) Oxalate nephrocalcinosis: a study in autopsied infants and neonates. Pediatr Pathol Lab Med 16:479–488PubMed

30.

Schell-Feith EA, Kist-van Holthe JE, Conneman N, van Zwieten PH, Holscher HC, Zonderland HM, Brand R, van der Heijden BJ (2000) Etiology of nephrocalcinosis in preterm neonates: association of nutritional intake and urinary parameters. Kidney Int 58:2102–2110PubMed

31.

Woolfield N, Haslam R, Le Quesne G, Chambers HM, Hogg R, Jureidini K (1988) Ultrasound diagnosis of nephrocalcinosis in preterm infants. Arch Dis Child 63:86–88PubMedPubMedCentral

32.

Cumming WA, Ohlsson A (1984) Nephrocalcinosis in Bartter’s syndrome. Demonstration by ultrasonography. Pediatr Radiol 14:125–126PubMed

33.

Barcia JP, Strife CF, Langman CB (1997) Infantile hypophosphatasia: treatment options to control hypercalcemia, hypercalciuria, and chronic bone demineralization. J Pediatr 130:825–828PubMed

34.

Mathias RS (2000) Rickets in an infant with Williams syndrome. Pediatr Nephrol 14:489–492PubMed

35.

Pahari A, Milla PJ, van WG (2003) Neonatal nephrocalcinosis in association with glucose-galactose malabsorption. Pediatr Nephrol 18:700–702PubMed

36.

Karlen J, Aperia A, Zetterstrom R (1985) Renal excretion of calcium and phosphate in preterm and term infants. J Pediatr 106:814–819PubMed

37.

Giapros VI, Papaloukas AL, Andronikou SK (2007) Urinary mineral excretion in preterm neonates during the first month of life. Neonatology 91:180–185PubMed

38.

Rockwell GF, Morgan MJ, Braden G, Campfield TJ (2007) Preliminary observations of urinary calcium and osteopontin excretion in premature infants, term infants and adults. Neonatology 93:241–245PubMed

39.

Pope JC 4th, Trusler LA, Klein AM, Walsh WF, Yared A, Brock JW 3rd (1996) The natural history of nephrocalcinosis in premature infants treated with loop diuretics. J Urol 156:709–712PubMed

40.

Rose B, Post T (2001) Clinical physiology of acid-base and electrolyte disorders, 5th edn. McGraw-Hill, New York, p 449

41.

Mirochnick MH, Miceli JJ, Kramer PA, Chapron DJ, Raye JR (1988) Furosemide pharmacokinetics in very low birth weight infants. J Pediatr 112:653–657PubMed

42.

Peterson RG, Simmons MA, Rumack BH, Levine RL, Brooks JG (1980) Pharmacology of furosemide in the premature newborn infant. J Pediatr 97:139–143PubMed

43.

Toffolo A, Trevisanuto D, Meneghetti S, Talenti E, Zacchello G, Zanardo V (1997) Non-furosemide-related renal calcifications in premature infants with bronchopulmonary dysplasia. Acta Paediatr Jpn 39:433–436PubMed

44.

Halliday HL, Ehrenkranz RA (2001) Delayed (> 3 weeks) postnatal corticosteroids for chronic lung disease in preterm infants. Cochrane Database Syst Rev CD001145

45.

Halliday HL, Ehrenkranz RA (2001) Early postnatal (< 96 hours) corticosteroids for preventing chronic lung disease in preterm infants. Cochrane Database Syst Rev CD001146

46.

Halliday HL, Ehrenkranz RA (2001) Moderately early (7–14 days) postnatal corticosteroids for preventing chronic lung disease in preterm infants. Cochrane Database Syst Rev CD001144

47.

Kamitsuka MD, Williams MA, Nyberg DA, Fox KA, Lee DL, Hickok D (1995) Renal calcification: a complication of dexamethasone therapy in preterm infants with bronchopulmonary dysplasia. J Perinatol 15:359–363PubMed

48.

Cranefield DJ, Odd DE, Harding JE, Teele RL (2004) High incidence of nephrocalcinosis in extremely preterm infants treated with dexamethasone. Pediatr Radiol 34:138–142PubMed

49.

Zanardo V, Dani C, Trevisanuto D, Meneghetti S, Guglielmi A, Zacchello G, Cantarutti F (1995) Methylxanthines increase renal calcium excretion in preterm infants. Biol Neonate 68:169–174PubMed

50.

Mazkereth R, Laufer J, Jordan S, Pomerance JJ, Boichis H, Reichman B (1997) Effects of theophylline on renal function in premature infants. Am J Perinatol 14:45–49PubMed

51.

Gouyon JB, Guignard JP (1987) Renal effects of theophylline and caffeine in newborn rabbits. Pediatr Res 21:615–618PubMed

52.

Rose B, Post T (2001) Clinical physiology of acid-base and electrolyte disorders, 5th edn. McGraw-Hill, New York, p 313

53.

Tsang R, Lucas A, Uauy R, Zlotkin S (1993) Calcium, magnesium and vitamin D. In: Nutritional needs of the preterm infant: scientific basis and practical guidelines. Williams and Wilkins, New York, p 135

54.

Rigo J, Pieltain C, Salle B, Senterre J (2007) Enteral calcium, phosphate and vitamin D requirements and bone mineralization in preterm infants. Acta Paediatr 96:969–974PubMed

55.

Rose B, Post T (2001) Clinical physiology of acid-base and electrolyte disorders, 5th edn. McGraw-Hill, New York, pp 201–202

56.

Bert S, Gouyon JB, Semama DS (2004) Calcium, sodium and potassium urinary excretion during the first five days of life in very preterm infants. Biol Neonate 85:37–41PubMed

57.

Hoppe B, Hesse A, Neuhaus T, Fanconi S, Forster I, Blau N, Leumann E (1993) Urinary saturation and nephrocalcinosis in preterm infants: effect of parenteral nutrition. Arch Dis Child 69:299–303PubMedPubMedCentral

58.

Hoppe B, Hesse A, Neuhaus T, Fanconi S, Blau N, Roth B, Leumann E (1997) Influence of nutrition on urinary oxalate and calcium in preterm and term infants. Pediatr Nephrol 11:687–690PubMed

59.

Berard E, Dageville C, Bekri S, Boutté P, Coussement A, Mariani R (1995) Nephrocalcinosis and prematurity: importance of urate and oxalate excretion. Nephron 69:237–241PubMed

60.

Campfield T, Braden G (1989) Urinary oxalate excretion by very low birth weight infants receiving parenteral nutrition. Pediatrics 84:860–863PubMed

61.

Campfield T, Braden G, Flynn-Valone P, Clark N (1994) Urinary oxalate excretion in premature infants: effect of human milk versus formula feeding. Pediatrics 94:674–678PubMed

62.

Reusz GS, Latta K, Hoyer PF, Byrd DJ, Ehrich JH, Brodehl J (1990) Evidence suggesting hyperoxaluria as a cause of nephrocalcinosis in phosphate-treated hypophosphataemic rickets. Lancet 335:1240–1243PubMed

63.

Murphy JL, Mendoza SA (1990) Decreased urinary citrate in premature infants with lung disease. Child Nephrol Urol 10:76–80PubMed

64.

Sikora P, Roth B, Kribs A, Michalk DV, Hesse A, Hoppe B (2003) Hypocitraturia is one of the major risk factors for nephrocalcinosis in very low birth weight (VLBW) infants. Kidney Int 63:2194–2199PubMed

65.

White MP, Aladangady N, Rolton HA, McColl JH, Beattie J (2005) Urinary citrate in preterm and term babies. Early Hum Dev 81:319–323PubMed

66.

Khan SR, Kok DJ (2004) Modulators of urinary stone formation. Front Biosci 9:1450–1482PubMed

67.

Verhulst A, Asselman M, De Naeyer S, Vervaet BA, Mengel M, Gwinner W, D, Haese PC, Verkoelen CF, De Broe ME (2005) Preconditioning of the distal tubular epithelium of the human kidney precedes nephrocalcinosis. Kidney Int 68:1643–1647PubMed

68.

Osorio AV, Alon MM, Nichols MA, Alon US (1998) Effect of age on furosemide-induced nephrocalcinosis in the rat. Biol Neonate 73:306–312PubMed

69.

Downing GJ, Egelhoff JC, Daily DK, Thomas MK, Alon U (1992) Kidney function in very low birth weight infants with furosemide-related renal calcifications at ages 1 to 2 years. J Pediatr 120:599–604PubMed

70.

Schell-Feith EA, Kist-van Holthe JE, van Zwieten PH, Zonderland HM, Holscher HC, Swinkels DW, Brand R, Berger HM, van der Heijden BJ (2003) Preterm neonates with nephrocalcinosis: natural course and renal function. Pediatr Nephrol 18:1102–1108PubMed

71.

Jones CA, King S, Shaw NJ, Judd BA (1997) Renal calcification in preterm infants: follow up at 4–5 years. Arch Dis Child Fetal Neonatal Ed 76:F185–F189PubMedPubMedCentral

72.

Ezzedeen F, Adelman RD, Ahlfors CE (1988) Renal calcification in preterm infants: pathophysiology and long-term sequelae. J Pediatr 113:532–539PubMed

73.

Saarela T, Lanning P, Koivisto M (1999) Prematurity-associated nephrocalcinosis and kidney function in early childhood. Pediatr Nephrol 13:886–890PubMed

74.

Porter E, McKie A, Beattie TJ, McColl JH, Aladangady N, Watt A, White MP (2006) Neonatal nephrocalcinosis: long term follow up. Arch Dis Child Fetal Neonatal Ed 91:F333–F336PubMedPubMedCentral

75.

Kist-van Holthe JE, van Zwieten PH, Schell-Feith EA, Zonderland HM, Holscher HC, Wolterbeek R, Veen S, Frolich M, van der Heijden BJ (2007) Is nephrocalcinosis in preterm neonates harmful for long-term blood pressure and renal function? Pediatrics 119:468–475PubMed

76.

Keijzer-Veen MG, Finken MJ, Nauta J, Dekker FW, Hille ET, Frölich M, Wit JM, van der Heijden AJ, Dutch POPS-19 Collaborative Study Group (2005) Is blood pressure increased 19 years after intrauterine growth restriction and preterm birth? A prospective follow-up study in The Netherlands. Pediatrics 116:725–731PubMed

77.

Barker DJ (1992) The fetal origins of adult hypertension. J Hypertens [Suppl 10]:S39–S44PubMed

78.

Jones CA, Bowden LS, Watling R, Ryan SW, Judd BA (2001) Hypercalciuria in ex-preterm children, aged 7–8 years. Pediatr Nephrol 16:665–671PubMed

79.

Reusz GS, Dobos M, Tulassay T, Miltényi M (1993) Hydrochlorothiazide treatment of children with hypercalciuria: effects and side effects. Pediatr Nephrol 7:699–702PubMed

80.

Knoll S, Alon US (2000) Effect of thiazide on established furosemide-induced nephrocalcinosis in the young rat. Pediatr Nephrol 14:32–35PubMed

81.

Leumann E, Hoppe B, Neuhaus T (1993) Management of primary hyperoxaluria: efficacy of oral citrate administration. Pediatr Nephrol 7:207–211PubMed

82.

Schell-Feith EA, Moerdijk A, van Zwieten PH, Zonderland HM, Holscher HC, Kist-van Holthe J, van der Heijden BJ (2006) Does citrate prevent nephrocalcinosis in preterm neonates? Pediatr Nephrol 21:1830–1836PubMed

Title: Nephrocalcinosis in preterm neonates
Authors: Eveline A. Schell-Feith
Joana E. Kist-van Holthe
Albert J. van der Heijden
Publication date: 01-02-2010
Publisher: Springer Berlin Heidelberg
Published in: Pediatric Nephrology / Issue 2/2010
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI: https://doi.org/10.1007/s00467-008-0908-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Nephrocalcinosis in preterm neonates

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 2/2010

Adequate use of allele frequencies in Hispanics—a problem elucidated in nephrotic syndrome

Post-renal transplantation hypophosphatemia

Extreme hypernatraemia, breast-feeding and red skin

Pre- and postcaptopril renal scintigraphy as a screening test for renovascular hypertension in children

Pharmacokinetics of tacrolimus in stable paediatric renal transplant recipients

Acute peritoneal dialysis in very low birth weight neonates using a vascular catheter