INTRODUCTION: Patients with renal failure who are being treated with dialysis 
frequently develop neuromuscular manifestations. Renal failure-associated 
calciphylaxis, also termed calcific uremic arteriolopathy (CUA), is a 
life-threatening condition usually observed in patients with end-stage renal 
disease on chronic dialysis or after renal transplantation.
METHODS: We describe a hemodialyzed patient who presented with rapidly 
progressive unexplained systemic vasculopathy, muscle atrophy, and proximal 
weakness, that unexpectedly proved to be caused by calciphylaxis.
RESULTS: Quadriceps muscle biopsy disclosed diffuse vascular calcific deposits 
on medium- and small-sized vessels, characteristic of CUA. Other changes 
included ischemic myopathy, focal intracellular calcium accumulation within 
myofibers, and calcium deposits in endomysial capillaries associated with marked 
complement activation and C5b9 formation.
CONCLUSION: There are only a few descriptions of muscle involvement in the 
context of CUA, a condition with a prognosis that depends on early diagnosis and 
treatment. This report underscores the usefulness of muscle biopsy in the 
diagnosis of systemic calciphylaxis. Muscle Nerve 56: 529-533, 2017.