Tumoral calcinosis and calciphylaxis presenting in a dialysis patient

Tumoral calcinosis and calciphylaxis are uncommon complications of haemodialysis therapy and are associated with poor phosphate and calcium control. The use of calcium containing phosphate-binding agents in conjunction with high calcium dialysates may exacerbate these conditions by inducing a positive calcium balance. Despite their common aetiology, the two disorders are seldom reported to occur in the same patient. We describe the case of a patient who presented with both tumoral calcinosis and calciphylaxis and subsequently developed devastating vascular complications. This case highlights the morbidity and mortality associated with these diseases, the importance of strict calcium/phosphate control and the dangers of positive calcium balance in dialysis patients.