Should we screen preterm infants for nephrocalcinosis? An evidence-based decision

Abstract

Nephrocalcinosis is increasingly recognized in premature infants in the neonatal intensive care unit based on ultrasound findings of increased echogenicity in medullary pyramids. Nephrolithiasis with obstruction of the urinary tract, urinary tract infection and hematuria may occur in the short-term, and renal dysfunction (e.g., glomerulus, proximal tubules and distal tubules), hypercalciuria, decreased growth of the kidney and hypertension may occur in the long-term. The primary goal of this review is to use the WHO’s screening criteria to determine whether nephrocalcinosis is a suitable condition for screening. The scientific, medical, economic and ethical merit of screening premature infants for nephrocalcinosis is appraised to answer the following question, “should preterm infants be screened for nephrocalcinosis?”