(A and B) Coronary intima plaque with subtle calcification in hematoxylin and eosin (H&E) stain (A) and Kossa stain (B). (A and B) Coronary intima plaque.

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(A and B) Coronary intima plaque with subtle calcification in hematoxylin and eosin (H&E) stain (A) and Kossa stain (B). (A and B) Coronary intima plaque with subtle calcification in hematoxylin and eosin (H&E) stain (A) and Kossa stain (B). Note that the arterial media is completely free of calcification. (C and D) Coronary artery of a patient with chronic kidney disease (CKD) showing intimal (*) as well as medial calcification (arrow). (C) H&E stain. (D) Kossa stain. (E) Medial calcification of a peripheral artery in the absence of any intimal change. Note that no lipid or cholesterol depositions are visible. (F) Peripheral muscular type artery with metaplastic bone formation in the arterial media (H&E stains). (G) Heavy calcification of the aortic media with rupture of elastic fiber in a subtotally nephrectomized rat with moderate chronic renal failure of 12 wk duration (Kossa stain). (H) X-ray of a patient with CKD and heavy medial calcification of the cubital and radial arteries and their branches as shown by the so-called tram track phenomenon (courtesy of Dr. Nonnast-Daniel, Department of Nephrology, University of Erlangen, Germany). Kerstin Amann CJASN 2008;3:1599-1605 ©2008 by American Society of Nephrology