Morphology, progression, and regression of arterial and periarterial calcifications in patients with end-stage renal disease

The appearance of arterial calcifications over time was studied radiographically in 143 patients with end-stage renal disease. Of these, 85 patients had only slight calcifications; 58 had the well-known, linear, pipe stem-like arterial calcifications. In 44 of the 58, small nodular calcifications were noted, often external to the linear calcifications. Nine patients had larger periarterial calcifications, which have not been previously described to our knowledge. Arterial calcifications progressed in 82 of 143 patients (57%) and regressed in 19 (13%). During progression, thickening of the linear calcifications was often observed, and in ten patients this caused definite luminal narrowing. From 1976 to 1984, five of 71 patients (7%) required amputations; all five had marked arterial calcifications. Better controlled clinical studies are indicated to detect factors that may prevent the progression and promote the regression of arterial calcifications.