My kidney ultrasound report shows atherosclerotic calcifications on the aorta and nonspecific bilateral echogenic medullary renal pyramids. Please help.

Q. What could be the reason for atherosclerotic calcifications on the aorta and nonspecific bilateral echogenic medullary renal pyramids?

Answered by
Dr. Yash Kathuria
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Apr 28, 2023 and last reviewed on: May 30, 2023

Hi doctor,

I had an ultrasound done for my kidneys and the radiologist reported atherosclerotic calcifications seen on the aorta. Also noted nonspecific bilateral echogenic medullary renal pyramids.

Can you please tell me what this means?

Is there a big concern or cause?

Thank you.



Welcome to

The calcification shown in the aorta (a large vessel coming out of your heart) and the echogenic renal pyramids in your kidneys, seem to have a common cause. There is a possibility that calcium is building up in your heart vessels and kidneys. This kidney echogenicity is likely nephrocalcinosis which means stones in your kidneys. I would advise you to get some tests if not done already.

  1. Parathyroid hormone (PTH) level.
  2. Calcium level and phosphate level.
  3. Arterial blood gas.
  4. An extractable nuclear antigen (ENA).
  5. Vitamin D level.
    1. If you have any family history of similar problems.?
    2. Are you on any other drugs apart from Spironolactone?
    3. Why are you on Spironolactone?
    4. Do you have hypertension?
    5. Any other relevant history?

    Thank you.

Please answer the following questions.

Hi doctor,

Thank you for your answer.

I am only on Spirolactone and Asprin. I take Spironolactone for primary hyperaldosteronism and I take Asprin for antiphospholipid syndrome. I have hypertension only with standing when I lay down my blood pressure is low. When I stand up my blood pressure goes high.

Calcium buildup in the aorta, is that common?

How is it fixed?

Thank you.



Welcomed back to

Calcium buildup in the aorta is not common at your age. The investigations that I advised you would help us to know about the cause of it. Because this seems to be the reason for your renal medullary changes in USG (ultrasonography). Moreover, there have been very few reported cases of nephrocalcinosis (calcium stone in the kidney) with hyperaldosteronism. But first, we need to rule out other common causes. Yes, it can be fixed once we know the cause of it.

Thank you.

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