Abstract
We encountered a patient undergoing CAPD who had tumoral calcinosis caused by hyperphosphatemia and hypercalcemia. Combined aggressive correction of hyperphosphatemia with calcitonin and use of a low-calcium dialysate was very effective in treatment.
A 53-year-old male who had been on CAPD for 5 years was referred to our CAPD clinic with a chief complaint of painful swelling of his left elbow joint. Laboratory studies revealed hypercalcemia (11.2mg/dl), hyperphosphatemia (6.9mg/dl) and mild elevation of intact-PTH. X-ray examinations and bone scintigraphy showed ectopic calcification caused by excessive calcium and phosphate. The CAPD dialysate was changed to low calcium concentration (2.5mEq/l) and HD was performed with low-calcium dialysate (2.5mEq/l) to aggressively remove the calcium and phosphate. In addition, 40 units of eel calcitonin was administered 3 times a week for 6 months. Dramatic disappearance of the ectopic calcification was achieved during the 6-month treatment period.
Thus, this therapeutic strategy is worth trying before surgical treatment of ectopic calcification during CAPD.
