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Calcification in end-stage kidneys

L S Ibels, A C Alfrey, W E Huffer

The American Journal of Medicine

|July 1, 1981

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Calcium-phosphate deposits are frequent in end-stage renal disease (ESRD) kidneys, indicating calcification occurs during renal failure. This kidney calcification may accelerate disease progression.

Area of Science:

Nephrology
Pathology
Biochemistry

Background:

End-stage renal disease (ESRD) is associated with various complications.
The role of calcium-phosphate deposits in kidney damage requires further elucidation.

Purpose of the Study:

To determine the frequency and severity of calcium-phosphate deposits in end-stage kidneys.
To investigate the timing and potential impact of kidney calcification in renal failure.

Main Methods:

Analysis of 59 end-stage kidneys from patients with diverse renal diseases.
Quantification of calcium concentration using biochemical assays.
Histological examination for calcium deposition patterns.

Main Results:

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Elevated calcium levels ( > 2 SD above control) were found in 57 of 59 end-stage kidneys.

Mean kidney calcium concentration was significantly higher (157 +/- 24 mmol/kg) compared to controls (17 +/- 1 mmol/kg).

Calcium deposits were observed in tubular cells, basement membranes, and interstitium, suggesting calcification occurs during renal failure, not terminally.

Conclusions:

Calcium-phosphate deposits are a common finding in end-stage kidneys.
Kidney calcification appears to develop during the course of renal failure.
Accelerated renal functional deterioration may result from kidney calcification.