Calcium-phosphorus-product and medial calcinosis of arterial vessels.

Histology of vessels of the forearm in 227 hemodialysis patients showed med ial fibrosis more often than medial calcinosis or intimal sclerosis. In rel ation to primary disease of renal failure, glomerulonephritis occurred more often than diabetes mellitus or interstitial nephritis. In patients with t he histological state of medial calcinosis, diabetes was the most often pri mary disease of renal failure. Calcium-phosphorus product was significantly higher in patients with medial calcinosis than in patients with medial fib rosis. A significantly higher calcium-phosphorus product was found in the s tate of medial calcinosis in patients with gastrointestinal/liver diseases and "abuse patients" than in patients getting Al(OH)(3) therapy. Continuous calcification of vessels in patients with medial calcinosis in histology o f arterial wall appeared in X-rays of pelvis earlier than in X-rays of the hands. The frequency of medial calcinosis increases in older patients with diabetes and hypertension. Both secondary HPT and osteopenia can lead to me dial calcinosis. An excessive suppression of secondary HPT can promote deve lopment of medial calcinosis - in individual case even Al3+ can be found in arterial wall. We must distinguish calcifying continuous uremic arteriolop athy and non-continuous arteriosclerotic formation of plaques. A correlatio n is found between dimension of calcification of aorta and the level of cal cium-phosphorus product, diabetics tend to marked calcifications. The death rate of hemodialysis patients increases with ascending levels of calcium-p hosphorus product. Calcium and PTH (parathyroid hormone) is not so importan t in the development of arteriosclerosis and calcinosis of vessels as calci um-phosphorus product.