A 67-year-old woman is admitted to the hospital due to worsening abdominal pain. The patient has long-term end-stage renal disease caused by diabetic nephropathy, for which she receives hemodialysis three times per week. The temperature is 37 degrees Celsius (98.6 degrees F), the blood pressure is 159/79 mm Hg, the pulse rate is 97 bpm, and the respirations rate is 16 /minute. High-pitched bowel sounds and mild distension without rebound tenderness are seen on abdominal examination. Blood urea nitrogen and creatinine levels are elevated, according to laboratory results. A small bowel obstruction is visible on a noncontrast CT scan of the abdomen. The arrows in the abdominal CT scan below show the following findings in the patient: Which of the following most likely contributed to the observed findings?

Question

A 67-year-old woman is admitted to the hospital due to worsening abdominal pain. The patient has long-term end-stage renal disease caused by diabetic nephropathy, for which she receives hemodialysis three times per week. The temperature is 37 degrees Celsius (98.6 degrees F), the blood pressure is 159/79 mm Hg, the pulse rate is 97 bpm, and the respirations rate is 16 /minute. High-pitched bowel sounds and mild distension without rebound tenderness are seen on abdominal examination. Blood urea nitrogen and creatinine levels are elevated, according to laboratory results. A small bowel obstruction is visible on a noncontrast CT scan of the abdomen. The arrows in the abdominal CT scan below show the following findings in the patient:  Which of the following most likely contributed to the observed findings?

Quizplus · Accepted Answer

Eductional Objective: Vascular calcifications are more common in chronic kidney disease patients due to electrolyte abnormalities (e.g., hyperphosphatemia, hypercalcemia) and chronic inflammation (secondary to atherosclerosis and/or uremia). These changes promote calcification while suppressing calcification inhibitors, resulting in extensive vascular calcifications.

A 67-Year-Old Woman Is Admitted to the Hospital Due to Worsening