Clinical outcome of infantile renal calcification
Abstract Purpose With popularization of prenatal ultrasonogram(US), postnatal US during the infantile period has also become popular for various reasons including fetal hydronephrosis. We investigated the clinical outcome of incidentally detected calcification on US in children younger than 1 year. Material and methods We retrospectively reviewed the US findings and medical records of 25 children below the age of 1 in whom renal calcification was detected on US between January 2003 and April 2007. Results The mean age of subjects was 4 months and renal calcification was bilateral in 5. Of the 29 renal units showing calcification fetal hydronphrosis was detected in 12 (41.4%), high grade hydronephrosis (grade III, IV, SFU) was found in 13(44.8%) and mild hydronephrosis was noted in 16(55.1%). 9 renal units showed multiple calcification and the mean size was 5.9mm. Associated anomalies included 5 UPJOs, 3 obstructive megaureters, 1 ureteocele, 2 VUR and 2 contralateral multicystic dysplastic kidneys. The calcification was radioopaque in 17 renal units. Calcification in 19(66%) of 29 renal units showed spontaneous resolution and the mean time to spontaneous resolution was 4 months. Of the remaining 10 renal units with persistent calcification, ESWL was performed in 7 renal units, anatrophic nephrolithotomy in 1, pyelolithotomy in 1 due to an increase in stone size or UTI and ureteroscopic stone removal was done in 1 due to migrated stone into the ureter. Conclusions Since spontaneous resolution could be observed quite frequently, expectant management with follow up U/S can be recommended for infantile calcification without symptoms.