Pulmonary Metastatic Calcifications Secondary to Chronic Renal Failure

Pulmonary metastatic calcification (PMC) is a rare but significant condition associated with chronic renal failure, particularly in patients undergoing long-term hemodialysis. PMC results from abnormal calcium-phosphate metabolism, leading to ectopic deposition of calcium salts in lung tissues. It can also occur due to hypercalcemia, primary and secondary hyperparathyroidism, excessive exogenous administration of calcium and vitamin D, sarcoidosis, milk-alkali syndrome, osteoporosis, renal or liver transplantation, and Paget's disease. Pathogenesis involves hyperphosphatemia, secondary hyperparathyroidism, and systemic dysregulation of calcium homeostasis. This condition is often asymptomatic but may present with progressive dyspnea, hypoxemia, or radiographic abnormalities such as diffuse or nodular opacities on imaging studies. Diagnosis relies on a combination of clinical history, laboratory findings, imaging, and, in some cases, histological confirmation. Management focuses on correcting the underlying metabolic derangements, including controlling serum phosphate and calcium levels through dietary restrictions, phosphate binders, calcimimetics, and optimizing dialysis. In severe cases, lung transplantation may be considered. Early recognition and prompt intervention are crucial to prevent complications and enhance patient outcomes. Here, we present a 60-year-old patient with pulmonary metastatic calcifications secondary to chronic renal failure.