Journal of Nephrology

, Volume 29, Issue 1, pp 129–131 | Cite as

Reversible vascular calcifications associated with hypervitaminosis D

  • Massimo CirilloEmail author
  • Giancarlo Bilancio
  • Chiara Cirillo
Case Report


A 64-year-old man was hospitalized in 2002 with symptoms of stupor, weakness, and renal colic. The clinical examination indicated borderline hypertension, small masses in the glutei, and polyuria. Laboratory tests evidenced high serum concentrations of creatinine, calcium, and phosphate. Imaging assessments disclosed widespread vascular calcifications, gluteal calcifications, and pelvic ectasia. Subsequent lab tests indicated suppressed serum parathyroid hormone, extremely high serum 25-hydroxy vitamin D, and normal serum 1,25-dihydroxy vitamin D. Treatment was started with intravenous infusion of saline and furosemide due to the evidence of hypercalcemia. Prednisone and omeprazole were added given the evidence of hypervitaminosis D. The treatment improved serum calcium, kidney function, and consciousness. The medical history disclosed recent treatment with exceptionally high doses of slow-release intra-muscular cholecalciferol and the recent excretion of urinary stones. The patient was discharged when it was possible to stop the intravenous treatment. The post-discharge treatment included oral hydration, furosemide, prednisone and omeprazole for approximately 6 months up to complete resolution of the hypercalcemia. The patient came back 12 years later because of microhematuria. Lab tests were normal for calcium/phosphorus homeostasis and kidney function. Imaging tests indicated only minor vascular calcifications. This is the first evidence of reversible vascular calcifications secondary to hypervitaminosis D.


Vitamin D Cholecalciferol Hypercalcemia Vascular calcification 


Compliance with the ethical standards

Conflict of interest

The authors have no interest to disclose.

Ethical approval

All procedures performed in studies involving the patient included in the case report were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed written consent was obtained from the patient included in the case report.


  1. 1.
    Kovacic JC, Moreno P, Nabel EG, Hachinski V, Fuster V (2011) Cellular senescence, vascular disease, and aging. Circulation 123:1900–1910PubMedCrossRefGoogle Scholar
  2. 2.
    Amann K (2008) Media calcification and intima calcification are distinct entities in chronic kidney disease. Clin J Am Soc Nephrol 3:1599–1605PubMedCrossRefGoogle Scholar
  3. 3.
    Kendrick J, Chonchol M (2011) The role of phosphorus in the development and progression of vascular calcification. Am J Kidney Dis 58:826–834PubMedPubMedCentralCrossRefGoogle Scholar
  4. 4.
    Duranton F, Rodriguez-Ortiz ME, Duny Y, Rodriguez M, Daurès JP, Argilés A (2013) Vitamin D treatment and mortality in chronic kidney disease: a systematic review and meta-analysis. Am J Nephrol 37:239–248PubMedCrossRefGoogle Scholar
  5. 5.
    Niederhoffer N, Bobryshev YV, Lartaud-Idjouadiene I, Giummelly P, Atkinson J (1997) Aortic calcification produced by vitamin D3 plus nicotine. J Vasc Res 34:386–398PubMedCrossRefGoogle Scholar
  6. 6.
    Bas A, Lopez I, Perez J, Rodriguez M, Aguilera-Tejero E (2006) Reversibility of calcitriol-induced medial artery calcification in rats with intact renal function. J Bone Miner Res 21:484–490PubMedCrossRefGoogle Scholar
  7. 7.
    Kerr DNS (1997) Hypercalcemia and metastatic calcification. Cardiovasc Res 36:293–297PubMedCrossRefGoogle Scholar
  8. 8.
    Davies MD, Mawer EB, Freemont AJ (1986) The osteodystrophy of hypervitaminosis D: a metabolic study. Q J Med 61:911–919PubMedGoogle Scholar
  9. 9.
    Kanis JA, Russell RGG (1977) Rate of reversal of hypercalcaemia and hypercalciuria induced by vitamin D and its 1α-hydroxylated derivatives. Br Med J 1:78PubMedPubMedCentralCrossRefGoogle Scholar
  10. 10.
    Butler RC, Dieppe PA, Keat ACS (1985) Calcinosis of joints and periarticular tissues associated with vitamin D intoxication. Ann Rheum Dis 44:494–498PubMedPubMedCentralCrossRefGoogle Scholar
  11. 11.
    Sato K, Emoto N, Toraya S, Tsushima T, Demura H, Tsuji N, Inaba S, Takeuchi A, Kobayashi T (1994) Progressively increased 1,25-dihydroxyvitamin D2 concentration in a hypoparathyroid patient with protracted hypercalcemia due to vitamin D2. Endocr J 41:329–337PubMedCrossRefGoogle Scholar

Copyright information

© Italian Society of Nephrology 2015

Authors and Affiliations

  • Massimo Cirillo
    • 1
    Email author
  • Giancarlo Bilancio
    • 1
  • Chiara Cirillo
    • 2
  1. 1.Department of Medicine and SurgeryUniversity of Salerno, Campus of MedicineBaronissi (SA)Italy
  2. 2.Department of Cardiothoracic and Respiratory SciencesSecond University of NaplesNaplesItaly

Personalised recommendations