Tumorous bursal calcifications due to undesolved phosphate-binding agents in chronic hemodialysis

The most important factor that appears to be associated with soft-tissue calcifications in uremics clinically is the increase of serum-phosphate levels, especially if the calcium-phosphate product exceeds the value of 75 (concentrations in mg/dl). In contrast to previous years tumoral paraarticular calcinosis is now rarely seen because much more attention has been paid to the prevention of hyperphosphatemia and because of pharmacological improvement of phosphate binding agents. Therefore, the level of serum phosphate in hemodialysed patients primarely depends on the patients adherence to the low phosphate diet and compliance with the phosphate binding therapy. We want to report of a patient on chronic intermittent hemodialysis who developed tremendous paraarticular soft tissue calcifications during a short period of time due to uncontrolled hyperphosphatemia despite correct intake of phosphate binding compounds. (orig.)