A case of medullary nephrocalcinosis develped in relatively low dose furosemide abuser in adult

Abstract

The long-term use of high dose furosemide is associated with medullary nephrocalcinosis in adults. The recent reports reveals that the development of medullary nephrocalcinosis is more associated with the daily dose of furosemide than the duration of medication. However, dose of furosemide that initiate medullary nephrocalcinosis is not known. We report a case of medullary nephrocalcinosis developed in adult patient taken relatively low dose furosemide. A 28 year-old woman showed hypokalemia, metabolic alkalosis, and medullary nephrocalcinosis on ultrasonographic evaluation. We discovered that she had taken the furosemide since 44 months ago. The average dose of furosemide taken by the patient was 0.26～1.15 mg/kg/day, and this dose was much smaller than recently reported dose of furosemide associated with medullary nephrocalcinosis in adults. Thus one should be alert for the development of medullary nephrocalcinosis in therapeutic dose of long-term furosemide use and educate the possible abuser for the development of medullary nephrocalcinosis.