This is a follow-up report of a patient who was originally reported because of the associations of chronic renal failure and acidosis with elastic-staining fibers in tendon. The patient lived another twenty months, with acidosis only partly corrected; extensive but inconstant calcification developed in subcutaneous tissues and tendons. At autopsy he also had calcification in viscera, usually in areas of positive staining to elastic stains or periodic acid-Schiff stain, or both.
Some aspects of soft-tissue calcification are reviewed, and the suggestion offered that prolonged acidosis can lead to changes in tissue protein which favor calcium deposition.