Renal infarction as a cause of a calcified renal mass

Calcification in a renal mass is not uncommon and is usually considered to be associated with malignancy, particularly when central in location. The following case describes renal calcification resulting from infarction. A 55-year-old woman was admitted as an emergency in renal failure following a history of several days of nausea and vomiting. In the past she had had both aortic and mitral valve replacements for rheumatic heart disease and as a result was taking digoxin, frusemide and Warfarin. On admission her serum digoxin level was 4.63 ng/ml (normal range 0.8−2.0 ng/ml) and this was thought to account for her symptoms. Further investigation revealed her blood urea to be 102 m.mol/1 and potassium 6.3 m.mol/1. Serum calcium was normal. An emergency ultrasound examination was performed to exclude ureteric obstruction and she was started on peritoneal dialysis.