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NDT Advance Access originally published online on January 12, 2006
Nephrology Dialysis Transplantation 2006 21(3):807-810; doi:10.1093/ndt/gfk040
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© The Author [2006]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Teaching Point
(Section Editor: A. Meyrier)

Sudden onset of adult respiratory distress syndrome (ARDS) in a long standing chronic haemodialysis patient with lung calcification

Andrew Davenport

Consultant Renal Physician/Honorary Senior Lecturer, University College London Center for Nephrology, Royal Free Hospital, Pond Street, London NW3 2QG

Correspondence and offprint requests to: Andrew Davenport, Consultant Renal Physician/Honorary Senior Lecturer, University College London Center for Nephrology, Royal Free Hospital, Pond Street, London NW3 2QG. Email: andrew.davenport@rfh.nthames.nhs.uk, Andrew.Davenport@royalfree.nhs.uk

Keywords: ARDS; haemodialysis; hyperparathyroidism; lung calcification

The first 150 words of the full text of this article appear below.



   Introduction
 
Patients with end-stage renal failure treated by haemodialysis have a marked increased risk for cardiovascular death. These patients have both an accelerated form of arteriosclerosis with calcification in atheromatous intimal plaques and also medial calcification due to Monckeberg's. In extreme cases soft tissue calcification can lead to calciphylaxis resulting in skin ulceration, amputation and death.

The present case describes a less frequently encountered problem due to vascular and soft tissue calcification, which presents management challenges to the renal physician.



   Case
 
A 57-year-old Northern European Caucasoid man was admitted for an elective parathyroidectomy. He had been on a regular thrice weekly haemodialysis for 14 years due to hypertensive renal disease. Both calcium-based phosphate binders and alfacalcidol had been prescribed since 1992. Due to difficulties with phosphate control, his calcium-based binders were switched to Alucaps®, between 1994 and 1998, and then again to Renagel® from July 2001 until the current admission. His intact . . . [Full Text of this Article]



   Discussion
 


   Teaching points
 

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