[3] During its early stages, nephrocalcinosis is visible on x-ray, and appears as a fine granular mottling over the renal outlines.

[4] Some of the symptoms that can happen are blood in the urine, fever and chills, nausea and vomiting, severe pain in the belly area, flanks of the back, groin, or testicles.

These include renal colic, polyuria and polydipsia:[4] There are several causes of nephrocalcinosis that are typically acute and present only with kidney failure.

[4] These include tumor lysis syndrome, acute phosphate nephropathy, and occasional cases of enteric hyperoxaluria.

[4] Nephrocalcinosis is connected with conditions that cause hypercalcaemia, hyperphosphatemia, and the increased excretion of calcium, phosphate, and/or oxalate in the urine.

A high urine pH can lead to nephrocalcinosis but only if it is accompanied by hypercalciuria and hypocitraturia, since having a normal urinary citrate usually inhibits the crystallization of calcium.

[10] If no underlying cause can be found then urine collection should be done for 24 hours and measurements of the excretion of calcium, phosphate, oxalate, citrate, and creatinine are looked at.

[10] Increasing fluid intake to yield a urine output of greater than 2 liters a day can be advantageous for all patients with nephrocalcinosis.

If changing one's diet alone does not result in a suitable reduction of hypercalciuria, a thiazide diuretic can be administered in patients who do not have hypercalcemia.