Child Kidney Dis.  2021 Dec;25(2):117-121. 10.3339/jkspn.2021.25.2.117.

Extraskeletal Calcifications in Children with Maintenance Peritoneal Dialysis

• Oh E
• Min J
• Lim SH
• Kim JH
• Ha IS
• Kang HG
• Ahn YH

• KMID: 2524513
• DOI: http://doi.org/10.3339/jkspn.2021.25.2.117

Abstract

Chronic kidney disease (CKD)-mineral and bone disorder (CKD-MBD) is a common complication of CKD, often accompanied by extra-skeletal calcification in adult patients. As increased vascular calcification is predicted to increase cardiovascular mortality and morbidity, the revised Kidney Disease: Improving Global Outcomes guidelines recommend avoiding calcium-containing phosphate chelators. However, extra-skeletal calcification is less commonly noticed in pediatric patients. Here, we report our experience of such a complication in pediatric patients receiving maintenance peritoneal dialysis. Extra-skeletal calcification was noticed at the corneas, pelvic cavity, and soft tissues of the lower leg in 4 out of 32 patients on maintenance peritoneal dialysis. These patients experienced the aggravation of extra-skeletal calcifications during peritoneal dialysis, and 2 of them underwent excisional operations. It is required to monitor extra-skeletal calcifications in children on kidney replacement therapy.

Keyword

Chronic kidney disease-mineral and bone disorder; Pathologic calcification; Peritoneal dialysis

Figure

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  Fig. 1. Calcifications shown in patients. (A) Band keratopathy in the bilateral corneas (case 1) (B) Computerized tomography image of a palpable mass at the left flank and both hips (white arrows, case 2) (C) Incidentally found calcifications of the pelvic cavity (white arrows, case 3) (D) Palpable and slowly growing mass of the anterior tibial area (case 4).

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  Fig. 2. Pathological slide of the palpable mass. Both slides show fibroadipose tissues with calcifications. (green arrowhead, fibrosis; red arrowhead, adipose tissue; blue arrowhead, calcification) (A) Specimen obtained by needle biopsy (case 2) (B) Specimen obtained by excision (case 4).

Reference

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