Echogenic renal pyramids
Dr Jeremy Jones and Dr Hani Alsalam et al.
Echogenic renal pyramids in children have variety of differential diagnosis.
Normal neonates
Nephrocalcinosis
Iatrogenic (most common cause)
- furosemide (frusemide)
- vitamin D
- steroids
Noniatrogenic
- idiopathic hypercalcemia
- Williams syndrome
- hyperparathyroidism
- milk-alkali syndrome
- Kenny-Caffey syndrome
- distal renal tubular acidosis
- malignant tumours
- chronic glomerulonephritis
- Sjogren syndrome (distal RTA)
Metabolic disease
- Lesch-Nyhan syndrome (urate)
- glycogen storage disease type 1A
- Wilson disease (distal RTA)
- Hurler mucopolysaccharidosis
- tyrosinemia
- cystinosis
Hypokalemia
- primary aldosteronism
- pseudo-Bartter syndrome
Protein deposition
- infant dehydration with presumed Tamm-Horsfall proteinuria / stasis nephropathy
- toxic shock syndrome
Vascular congestion
Infection
- candida / CMV nephritis
- AIDS-associated Mycobacterium avium-intracellulare
Fibrosis of the renal pyramids
Autosomal recessive polycystic kidney disease
Cystic medullary disease
- medullary sponge kidney
- congenital hepatic fibrosis with tubular ectasia
Intrarenal reflux
- chronic pyelonephritis
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