Review
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Pediatr. Dec 9, 2023; 12(5): 295-309
Published online Dec 9, 2023. doi: 10.5409/wjcp.v12.i5.295
Renal calcification in children with renal tubular acidosis: What a paediatrician ‎should ‎know‎
Mohammed Al-Beltagi, Nermin Kamal Saeed, Adel Salah Bediwy, Reem Elbeltagi, Samir Hasan, Mohamed Basiony Hamza
Mohammed Al-Beltagi, Department of Pediatrics, Faculty of Medicine, Tanta University, Tanta ‎ 31511‎, Alghrabia, Egypt
Mohammed Al-Beltagi, Department of Pediatrics, University Medical Center, King Abdulla Medical City, Dr. Sulaiman Al Habib ‎Medical ‎Group, Manama, Bahrain‎, Manama 26671, Manama, Bahrain
Nermin Kamal Saeed, Medical Microbiology Section, Department of Pathology, Salmaniya Medical Complex, ‎Ministry of Health, Kingdom of Bahrain, Manama 12, Manama, Bahrain
Nermin Kamal Saeed, Medical Microbiology Section, Department of Pathology, Irish Royal College of Surgeon, Bahrain, Busaiteen ‎15503‎, Muharraq, Bahrain
Adel Salah Bediwy, Department of Pulmonology, Faculty of Medicine, Tanta University, Tanta ‎‎ 31527, Alghrabia, Egypt
Adel Salah Bediwy, Department of Chest Disease, University Medical Center, King Abdulla Medical City, ‎‎Arabian Gulf University, Dr. Sulaiman Al Habib Medical Group, Manama‎, Manama ‎26671‎, ‎Manama, Bahrain
Reem Elbeltagi, Department of Medicine, The Royal College of Surgeons in Ireland - Bahrain, ‎Busiateen 15503, Muharraq, Bahrain
Samir Hasan, Department of Pediatrics, Faculty of Medicine, Tanta University Hospital, Tanta 31511, Algharbia, Egypt
Mohamed Basiony Hamza, Department of Pediatrics, Faculty of Medicine, Tanta University‎, Tanta ‎31511‎, Algharbia, Egypt
Author contributions: Al-Biltagi M developed the idea, collected the data, and wrote and revised the manuscript; Saeed NK, Bediwy AS, Hasan S, and Hamza MB collected the data and revised the manuscript from the laboratory aspect; Elbeltagi R collected the data, wrote the method section, and revised the manuscript.
Conflict-of-interest statement: All the authors declare that they have no conflict of interest to disclose.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Mohammed Al-Beltagi, MBChB, MD, MSc, PhD, Academic Editor, Chairman, Consultant Physician-Scientist, Professor, Researcher, Department of Pediatrics, Faculty of Medicine, Tanta University, Al Bahr Street, Tanta 31527, Algharbia, Egypt. mbelrem@hotmail.com
Received: July 29, 2023
Peer-review started: July 29, 2023
First decision: September 14, 2023
Revised: September 15, 2023
Accepted: October 16, 2023
Article in press: October 16, 2023
Published online: December 9, 2023
Abstract

Renal tubular acidosis (RTA) can lead to renal calcification in children, which can cause various complications and impair renal function. This review provides pediatricians with a comprehensive understanding of the relationship between RTA and renal calcification, highlighting essential aspects for clinical management. The article analyzed relevant studies to explore the prevalence, risk factors, underlying mechanisms, and clinical implications of renal calcification in children with RTA. Results show that distal RTA (type 1) is particularly associated with nephrocalcinosis, which presents a higher risk of renal calcification. However, there are limitations to the existing literature, including a small number of studies, heterogeneity in methodologies, and potential publication bias. Longitudinal data and control groups are also lacking, which limits our understanding of long-term outcomes and optimal management strategies for children with RTA and renal calcification. Pediatricians play a crucial role in the early diagnosis and management of RTA to mitigate the risk of renal calcification and associated complications. In addition, alkaline therapy remains a cornerstone in the treatment of RTA, aimed at correcting the acid-base imbalance and reducing the formation of kidney stones. Therefore, early diagnosis and appropriate therapeutic interventions are paramount in preventing and managing renal calcification to preserve renal function and improve long-term outcomes for affected children. Further research with larger sample sizes and rigorous methodologies is needed to optimize the clinical approach to renal calcification in the context of RTA in the pediatric population.

Keywords: Renal tubular acidosis, Nephrocalcinosis, Renal calcification, Hypercalciuria, Kidney stones, Metabolic acidosis, Children

Core Tip: Children with renal tubular acidosis (RTA) may develop renal calcification, leading to complications and negatively affecting kidney function. This comprehensive review aims to provide pediatricians with a better understanding of the connection between RTA and renal calcification, emphasizing key aspects of clinical management. Relevant studies were analyzed to examine the prevalence, risk factors, underlying mechanisms, and clinical implications of renal calcification in children with RTA. Nephrocalcinosis in type 1 RTA is mainly associated with a higher risk of renal calcification. Further research with larger sample sizes and rigorous methodologies is necessary to improve our understanding of RTA-related renal calcification.