Vascular calcification: When should we interfere in chronic kidney disease patients and how?

Figure 1 Male patient, 36-year-old, on regular hemodialysis for 8 years, presenting with multiple skin ulcers affecting both legs. A: His corrected serum calcium is 10.28 mg/dL and serum phosphorus 8 mg/dL. Serum PTH is 2588 pg/mL. He initially experienced itching papules that eventually ulcerated; B: Another ulcer with necrotic floor in the same patient. PTH: Parathyroid hormone.

Figure 2 Plain X-ray of the pelvis in hemodialysis patient for 52 mo showing extensive calcification of the right common and external iliac arteries (arrows).

Figure 3 Doppler study of popliteal artery, the vessel wall shows linear calcification.