Kidney Week

Abstract: PUB086

Treatment of Uremic Tumoral Calcinosis in Maintenance Hemodialysis Patients

Session Information

• Publication Only

Category: Dialysis

• 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

• Ke, Guibao, Department of Nephrology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences,, Guangzhou, China

Guibao Ke,

• Zhang, Fengxia, Department of Nephrology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences,, Guangzhou, China

Fengxia Zhang,

• Chen, Xueqin, Department of Nephrology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences,, Guangzhou, China

Xueqin Chen,

• Zhang, Hong, Department of Nephrology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences,, Guangzhou, China

Hong Zhang,

• Dou, Shuai Cao, Department of Nephrology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences,, Guangzhou, China

Shuai Cao Dou,

• Liang, Zhiwen, Department of Nephrology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences,, Guangzhou, China

Zhiwen Liang,

• Wei, Shi, Department of Nephrology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences,, Guangzhou, China

Shi Wei,

• Liang, Xinling, Department of Nephrology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences,, Guangzhou, China

Xinling Liang,

• Liu, Shuangxin, Department of Nephrology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences,, Guangzhou, China

Shuangxin Liu,

Background

Uremic tumoral calcinosis (UTC) is a rare disease with metastatic tissue calcification in maintenance hemodialysis (HD) patients. However, limited data are available on treatment of UTC in HD patients. This article mainly discusses the diagnostic findings and efficacy of treatment in HD patients with UTC.

Methods

A retrospective analysis was conducted on the data of 13 cases of UTC, including their clinical features, biochemical indicators, imaging findings, diagnosis, therapeutic methods and follow-up results. Parathyroidectomy (PTX) or drug treatment were determined based on intact parathyroid hormone (iPTH) levels and clinical symptoms.

Results

All of 13 patients were diagnosed as UTC definitely by imaging examination. The predominant areas involved were the buttocks (4 cases, 30.77%), shoulders (4 cases, 30.77%), and elbows (3 cases, 23.08%). Based on the levels of iPTH, cases were categorized into two different groups: PTX treatment group was associated with high levels of iPTH, while drug treatment group (lanthanum carbonate or sevelamer with STS) was lower iPTH. After PTX treatment, there was a significant decrease in serum iPTH, calcium (Ca), phosphate (P) and alkaline phosphatase (ALP) levels (p<0.05). In drug treatment group, the serum P levels was decreased significantly, along with a finding that hemoglobin levels was increased (p<0.05). All the UTC had lessened or even disappeared after treatment 4 to 6 months.

Conclusion

Although most UTC patients have an increased iPTH, a small number had lower iPTH levels. Based on iPTH levels and clinical symptoms, the patients were treated with PTX or drug therapy. With proper treatment, UTC disappeared without the need for surgery to remove calcinosis tissue.

Funding

• Government Support - Non-U.S.