Sonographic diagnosis of furosemide-induced nephrocalcinosis in newborn infants.

Abstract

In three newborn infants who had received furosemide for a variety of indications, strongly increased echogenicity in the pyramids of the renal medulla was seen on ultrasonography. In one infant the changes were unilateral, the contralateral kidney being nonfunctional because of probable renal artery thrombosis. One infant died and medullary nephrocalcinosis was confirmed post mortem radiologically as well as by computed tomography and anatomic-histologic examination of the kidneys.

Frusemide-induced nephrocalcinosis in very low birth weight infants

“…Other American authors have since described the radiographic and sonographic findings of frusemide induced nephrocalcinosis [2][3][4][5]. To our knowledge, no similar reports have been published in Britain.…”

“…Reports from North America have established the association of frusemide therapy and nephrocalcinosis in very low birth weight infants [1][2][3][4][5]. These babies had at least 10 days frusemide treatment, and usually 3 weeks or more.…”

“…These babies had at least 10 days frusemide treatment, and usually 3 weeks or more. One patient, however, only had a total of 2.6 mg [3]. Our patients were treated for 10 days, 21 days and 5 months respectively.…”

Ultrasound diagnosis of nephrocalcinosis in preterm infants.

“…Side effects include hyponatraemia, hypokalaemia, hypochloraemic metabolic alkalosis, and hypercalciuria.1 Urinary calcium excretion is increased 10-fold2 and this is thought to be the major factor in the development of nephrocalcinosis and nephrolithiasis. 3 The total dose may also be important. Osteopenia, from which premature infants are at risk, is also exacerbated.…”

Renal ultrasound in metabolic bone disease

“…Serial US in a baby on furosemide therapy [4] (Fig. 5) demonstrates a pattern similar to pattern III as an intermediate stage between the normal US in the newborn period and extensive medullary nephrocalcinosis present at age 11-½ months.…”