In acute renal failure with prolonged oliguria the demonstration of progressive shell-like cortical calcification is consistent with a diagnosis of acute cortical necrosis. This case report concerns the radiologic demonstration of renal cortical calcification in a child as early as the sixth day of hospitalization, following the onset of acute renal failure. Ultrasound is shown to be a useful tool in the evaluation of renal cortical calcification. Diagnosis of renal cortical calcification can be made by sonography, abdominal radiography or by tomography, and the unusually early development of such calcification may be influenced by a markedly elevated serum Ca × P product in acute renal failure.

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