Case report

A 33 year old woman developed chronic renal failure at the age of 15 as a result of medullary cystic kidneys. She underwent a renal transplant at the age of 17, which failed 6 years later and so she was maintained on continuous ambulatory peritoneal dialysis.

The patient subsequently developed refractory secondary hyperparathyroidism with ectopic calcification and reduced bone density. Her serum biochemistry between 1992 and 1997 showed a persistently high calcium phosphate product ranging between 3.6 and 8.9 mmol/l (normal range 1.6–3.4 mmol/l) with hypercalcaemia (2.36–2.71 mmol/l (normal range 2.0–2.4 mmol/l)) and hyperphosphataemia (2.36–3.42 mmol/l (normal range …