Overview
Nephrocalcinosis refers to the deposition of calcium salts in the renal parenchyma. Macroscopic nephrocalcinosis is characterized by visible calcifications on imaging studies.Diagnosis
Diagnosis is typically made via imaging, such as ultrasound or computed tomography (CT) 1.
The severity and distribution of calcifications can be assessed using imaging 1.Management
Percutaneous nephrolithotomy (PCNL) is a treatment option for renal stones, which can be associated with nephrocalcinosis 1.
Standard PCNL (tract size 30F) is associated with higher leakage, bleeding, blood transfusion, and renal pelvis perforation compared to mini-PCNL, but has a shorter operation time 1.
Tract size of 22-26F during PCNL was not found to be superior to 30F or mini-PCNL in terms of stone-free rates or complications 1.
Stone-free rates for standard PCNL and mini-PCNL are comparable, approximately 87.6% and 87.8%, respectively 1.Key Recommendations
Percutaneous nephrolithotomy is a management option for renal stones, with comparable stone-free rates between standard (30F tract) and mini-PCNL 1. (Evidence: Moderate)
Standard PCNL (30F tract) may be associated with increased complications such as bleeding and perforation compared to mini-PCNL, despite a potentially shorter operative time 1. (Evidence: Moderate)
Tract sizes of 22-26F for PCNL do not offer improved stone-free rates or reduced complications compared to 30F or mini-PCNL 1. (Evidence: Moderate)References
1 Deng J, Li J, Wang L, Hong Y, Zheng L, Hu J et al.. Standard versus mini-percutaneous nephrolithotomy for renal stones: a meta-analysis. Scandinavian journal of surgery : SJS : official organ for the Finnish Surgical Society and the Scandinavian Surgical Society 2021. link