Diffuse Uremic Tumoral Calcinosis in a Patient on Long-Term Hemodialysis

Abstract

Tumoral calcinosis is an uncommon and severe complication of hemodialysis therapy. The most important pathogenic factor involved in uremic tumoral calcinosis is an increase in calcium-phosphorus product, not necessarily related to hyperparathyroidism. We report here a patient on hemodialysis who presented with increasing multifocal and uncommon sites of massive calcifications. The patient was examined, and a diagnosis of uremic tumor calcinosis was made. The patient was treated with the noncalcemic phosphate binder sevelamer, a strict diet, multiple hemodialysis sessions per week, and a low calcium dialysate, with improvement on biological findings a decrease in the volume of some tumors on his fingers and a global stable disease. Some nodes in hands and feet disappeared; in other sites, their diameter was reduced, and the largest nodule decreased from 5- to 2-cm diameter.

Treatment of a soft tissue calcification in a patient receiving peritoneal dialysis

“…They all focus on aggressive treatment of hyperphosphatemia and avoidance of calcium loading, which appear to be essential to arrest future progress. Thus, medical therapy with discontinuing of calcium‐containing phosphate binders and alfacalcidiol together with a low calcium dialysate is essential in the treatment of soft tissue calcification …”

“…Secondary hyperparathyroidism is often present . Several authors had advocated the use of parathyroidectomy in patients with soft tissue calcifications and severe hyperparathyroidism .…”

“…Thus, medical therapy with discontinuing of calcium-containing phosphate binders and alfacalcidiol together with a low calcium dialysate is essential in the treatment of soft tissue calcification. [5][6][7][8][9][10][11][12][13][14][15] Secondary hyperparathyroidism is often present. 5,12 Several authors had advocated the use of parathyroidectomy in patients with soft tissue calcifications and severe hyperparathyroidism.…”

“…[5][6][7][8][9][10][11][12][13][14][15] Secondary hyperparathyroidism is often present. 5,12 Several authors had advocated the use of parathyroidectomy in patients with soft tissue calcifications and severe hyperparathyroidism. 5,9,11 In patients receiving hemodialysis complete remission was seen after parathyroidectomy.…”

The Impact of Chronic Kidney Disease - Mineral and Bone Disorder on the Locomotor System and Quality of Life in Hemodialysis Patients

“…The obstinate results less than 30% of patients complained of bone pain prevailed Periarticular soft tissue calcification symbolizes 5% of the study population, similar results, 4.9 % obtained by others (29). A dynamic bone disease, Ca xP product, vitamins D and K overload, aluminum intoxication, metabolic alkalosis, and tissue injury are implicated in pathogenesis of soft tissue calcification (32,33).…”