Successful treatment of tumoral calcinosis using CAPD combined with hemodialysis with low-calcium dialysate.
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.
Kuriyama
S
S
Division of Nephrology, Saiseikai Central Hospital, Tokyo, Japan.
Tomonari
H
H
Nakayama
M
M
Kawaguchi
Y
Y
Sakai
O
O
D000328:Adult; D002114:Calcinosis / Q000097:blood / Q000628:therapy*; D002118:Calcium / Q000097:blood; D006801:Humans; D008297:Male; D010531:Peritoneal Dialysis, Continuous Ambulatory; D006435:Renal Dialysis
D002118:Calcium