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Pulmonary Calcification in Chronic Dialysis Patients: Clinical and Pathologic Studies

J. D. CONGER, M.D., F.A.C.P.; W. S. HAMMOND, M.D.; A. C. ALFREY, M.D., F.A.C.P.; S. R. CONTIGUGLIA, M.D.; R. E. STANFORD, M.D.; and W. E. HUFFER, M.D.
[+] Article and Author Information

Grant support: in part by Veterans Administration research grant 0233.02 and by U.S. Public Health Service grant RR-51 from the General Clinical Research program of the Division of Research Resources, National Institutes of Health.

▸Requests for reprints should be addressed to John D. Conger, M.D., Veterans Administration Hospital, 1055 Clermont Street, Denver, CO 80220.


Denver, Colorado


Ann Intern Med. 1975;83(3):330-336. doi:10.7326/0003-4819-83-3-330
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A prospective study of 31 chronically hemodialyzed patients was made to investigate the incidence and pathology of pulmonary calcification and the relation of the latter to ventilatory function. Fifteen of the patients have died thus far; 9 had evidence of lung calcification. The lesions occurred predominately in alveolar septa and were associated with varying degrees of fibrosis and alveolar septal thickening. Only one patient had X-ray evidence of calcification. An X-ray diffraction analysis showed a predominant pattern of whitlockite (CaMg)3(Po4)2 in the deposits. Patients with the severest pulmonary calcification had abnormalities of vital capacity, carbon monoxide diffusion, and Po2. Serum calcium levels were slightly higher in patients with calcification, but there was no measurable association with the duration of dialysis, serum phosphorus, calcium X phosphorus product, magnesium, bicarbonate, or arterial pH. These data show that pulmonary calcification occurs with high frequency in patients undergoing long-term hemodialysis and that such lesions are associated with restrictive and diffusion ventilatory defects.

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