Echogenic renal pyramids in children can be due to many different causes.
Differential diagnosis
Nephrocalcinosis
Iatrogenic (most common cause)
- furosemide (frusemide)
- vitamin D
- steroids
Non-iatrogenic
- idiopathic hypercalcemia
- Williams syndrome
- hyperparathyroidism
- milk-alkali syndrome
- Kenny-Caffey syndrome
- distal renal tubular acidosis
- malignant tumors
- chronic glomerulonephritis
- Sjogren syndrome (distal RTA)
- sarcoidosis
Metabolic disease
- gout
- Lesch-Nyhan syndrome (urate)
- Fanconi syndrome
- glycogen storage disease type 1A
- Wilson disease (distal RTA)
- Hurler mucopolysaccharidosis
- alpha-1 antitrypsin deficiency
- tyrosinemia
- cystinosis
- oxalosis
- Crohn disease
Hypokalemia
Protein deposition
- infant dehydration with presumed Tamm-Horsfall proteinuria / stasis nephropathy
- toxic shock syndrome
Vascular congestion
Infection
- candida / cytomegalovirus (CMV) nephritis
- AIDS-associated Mycobacterium avium-intracellulare
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