1. Severe ectopic calcification of the intestinal wall in a patient on long-term continuous ambulatory peritoneal dialysis therapy 
Yoshifumi Ubara, MD, Hideyuki Katori, MD, Tetsuo Tagami, MD, Masafumi Yokota, MD, Akiko Kitamura, MD, Yoshio Matsushita, MD, Fumi Takemoto, MD, Toshikazu Imai, MD, Sumio Inoue, MD, Keihachirou Kuzuhara, MD, Shigeko Hara, MD, Akira Yamada, MD, Ryuko Takagawa, MD 
American Journal of Kidney Diseases 
Volume 35, Issue 4, Pages (April 2000)
DOI: /S (00)
Copyright © 2000 National Kidney Foundation, Inc Terms and Conditions

2. Fig 1
Clinical course. The patient was treated with 2 μg vitamin D3 derivatives (alfacalcidol or calcitriol) and 4 g calcium carbonate daily to prevent hypocalcemia and hyperphosphatemia from the start of CAPD. In 1993, calcitriol was increased to 2.5 μg daily. In May 1995, vitamin D3 derivative was changed from pill to liquid type, and the dose was increased to 5 μg daily 1 month later. In June 1996, subtotal parathyroidectomy (PTX) was performed. The times when the peritonitis occurred are showed by (▾). calcitriol: 1α,25-(OH)2 -D3 , alfacalcidol: 1α-OH-D3 .
American Journal of Kidney Diseases  , DOI: ( /S (00) )
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3. Fig 2
Plain abdominal radiography (A) and computed tomography (B) performed before the start of liquid vitamin D3 derivatives, in May 1995, showed no abnormalities except abdominal aortic calcification.
American Journal of Kidney Diseases  , DOI: ( /S (00) )
Copyright © 2000 National Kidney Foundation, Inc Terms and Conditions

4. Fig 2
Plain abdominal radiography (A) and computed tomography (B) performed before the start of liquid vitamin D3 derivatives, in May 1995, showed no abnormalities except abdominal aortic calcification.
American Journal of Kidney Diseases  , DOI: ( /S (00) )
Copyright © 2000 National Kidney Foundation, Inc Terms and Conditions

5. Fig 3
Plain abdominal radiography (A) and computed tomography (B) performed in October 1995, for the first time, showed a continuous line of calcification along the intestinal wall. The parietal peritoneum showed no calcification.
American Journal of Kidney Diseases  , DOI: ( /S (00) )
Copyright © 2000 National Kidney Foundation, Inc Terms and Conditions

6. Fig 3
Plain abdominal radiography (A) and computed tomography (B) performed in October 1995, for the first time, showed a continuous line of calcification along the intestinal wall. The parietal peritoneum showed no calcification.
American Journal of Kidney Diseases  , DOI: ( /S (00) )
Copyright © 2000 National Kidney Foundation, Inc Terms and Conditions

7. Fig 4
The entire peritoneum was dark brown in color. The visceral portion exhibited crepe-like longitudinal wrinkling and an elephant skin–like surface.
American Journal of Kidney Diseases  , DOI: ( /S (00) )
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8. Fig 5
Histology of the intestinal wall. The serosa (large arrow) of the small intestine was markedly thickened by collagen fibers. There were linear or macular calcified plaques (small arrows) between the serosa and the longitudinal layer (medium arrow) of the muscularis externa. The calcified plaques partially invaded the muscular layer (Hematoxylin-eosin staining, original magnification ×33).
American Journal of Kidney Diseases  , DOI: ( /S (00) )
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9. Fig 6
Histology of the intestinal wall. The remainder of the subserosal tissue was replaced by fibrosis, with only slight infiltration of inflammatory cells. Subserosal small arteries showed hyalinosis of the intima and the severely narrowed lumina (Azan staining, original magnification ×80).
American Journal of Kidney Diseases  , DOI: ( /S (00) )
Copyright © 2000 National Kidney Foundation, Inc Terms and Conditions