Resolution of tumoral calcinosis in a hemodialysis patient using low calcium dialysate

Vitamin D, phosphate, and vasculotoxicity

“…Supplementing active vitamin D metabolites is a routine treatment option for CKD patients. Use of a high calcium dialyzer bath and prolonged treatment of vitamin D are believed to cause tumoral calcinosis (Cofan et al 1999), as use of a low calcium bath and discontinuation of vitamin D therapy could delay or prevent such calcinosis (Franco et al 2005). In D r a f t 9 | P a g e various genetically modified mouse models, including FGF23 or Klotho knockout mice, extensive vascular calcification is noted with increased vitamin D activities (Nakatani et al 2009;.…”