title: Successful treatment of tumoral calcinosis using CAPD combined with hemodialysis with low-calcium dialysate.
abstract: Successful treatment of tumoral calcinosis using continuous ambulatory peritoneal dialysis (CAPD) combined with hemodialysis is described. A 32-year-old male patient with a 2-year history of CAPD rapidly developed multiple metastatic calcification (tumoral calcinosis) adjacent to his fingers, elbows, and knee joints. Tests showed severe hyperphosphatemia, moderate hypercalcemia, and increased Ca-P product without elevation of intact parathyroid hormone. An enlarged parathyroid gland was not found by echography. In order to rapidly lower the excessive Ca and P levels, a combined therapy with CAPD and vigorous transient hemodialysis using a low-Ca dialysate was performed. In parallel, the patient was given calcitonin, bisphosphonate, and short-term Al to ameliorate the metastatic calcifications more effectively. The result was dramatic with disappearance of the tumoral calcinosis as well as improvement in subjective symptoms within a few months. The present case suggests that combined therapy with hemodialysis and CAPD using a low-Ca dialysate, together with Ca-modulating agents, can be effective in ameliorating tumoral calcinosis in patients on CAPD.
authors.affiliation: Division of Nephrology, Saiseikai Central Hospital, Tokyo, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Kuriyama
authors.forename: H
authors.initials: H
authors.lastname: Tomonari
authors.forename: M
authors.initials: M
authors.lastname: Nakayama
authors.forename: Y
authors.initials: Y
authors.lastname: Kawaguchi
authors.forename: O
authors.initials: O
authors.lastname: Sakai
mesh_terms: D000328:Adult; D002114:Calcinosis / Q000097:blood / Q000628:therapy*; D002118:Calcium / Q000097:blood; D006801:Humans; D008297:Male; D010531:Peritoneal Dialysis, Continuous Ambulatory; D006435:Renal Dialysis
chemical_list: D002118:Calcium