TUMORAL CALCINOSIS IN HEMODIALYSIS - CONT RIBUTE THE INDUCTION OF A MODERATE DECREE OF HYPERPARATHYROIDISM TO ITS RESOLUTION

Tumoral carcinosis in uremic patients is characterized by deposits in periarticular areas of calcium salts, sometimes massive, and often req uiring surgical treatment We describe a patient on hemodialysis treatm ent with a intact PTH level in the high-normal range and high calcium- phospate product, who developed large periarticular calcifications par ticularly around the kness. The calcifications persisted despite contr ol of the calcium-phosphate product for one year. After beginning trea tment with low calcium dialysis fluid, and without changes in the amou nt of dialysis administered, we observed a moderate increase of the in tact PTH levels and almost total resorption of the deposits after eigh t months of treatment. We discuss the more accepted favoured explanati ons of tumoral calcinosis in dialysis patients. Although it is commonl y accepted that hyperparathyroidism is an important factor in inducing extraskeletal calcifications, our case and some others recently descr ibed suggest that a certain degree of parathyroid stimulation is benef icial, provided the calcium-phosphate product is controlled.