Mobile intracardiac calcinosis: a new risk of thromboembolism in patients with haemodialysed end stage renal disease

Cardiac calcinosis is a common complication of end stage renal disease. A n ewly observed risk of thromboembolism is reported in four patients with mob ile cardiac calcinosis, treated with long term dialysis. Rapidly growing mo bile calcification was confirmed by echocardiography. Each patient had an i mbalance in serum calcium x inorganic phosphate (Ca x P product greater tha n or equal to 50); this imbalance could not be treated due to the sudden de ath of the patient or the need for surgical resection to prevent recurrent cerebral thromboembolism. Histological examination revealed intracardiac ca lcinosis in three cases, and each case showed haemodialysis hypoparathyroid ism (intact PTH < 160 pg/ml). Thromboembolism in such cases is rare, howeve r it indicates a need for cautious echocardiographic monitoring in end stag e renal disease in patients with an uncontrolled Ca x P product.