Calcium deposition in the cardiac conduction system induces progressive arrhythmia and one study has shown a high percentage of second- and third-degree atrioventricular block (69%) with dialysis.6 Among the factors postulated to promote the development of metastatic calcification, both elevated calcium-phosphorus product and increased parathyroid hormone levels are possible, and exploration or removal of the parathyroid glands should be considered if heart block is present.7 Here, PTH is linked to atrioventricular block.