Abstract
Calciphylaxis or calcific uremic arteriolopathy is an infrequent complication of end stage kidney disease. It is characterized by arteriolar medial calcification, thrombotic cutaneous ischemia, tissue necrosis often leading to ulceration, secondary infection and increased mortality rates. Current, multimodality treatment involves local wound care, well-controlled calcium, phosphate and parathyroid hormone levels and combination therapy with sodium thiosulfate and hyperbaric oxygen therapy. This combination therapy may be changing the historically poor prognosis of calcific uremic arteriolopathy reported in the literature. Peritoneal dialysis is considered a risk factor based on limited publications, however this remains to be proven. Clinical presentation, diagnosis, pathogenesis and treatment of calcific uremic arteriolopathy in these patients are no different from other patients manifesting with this condition.
Highlights
Calcific uremic arteriolopathy (CUA), commonly referred to as calciphylaxis, is an uncommon but increasingly recognized disorder associated with high morbidity and mortality
The aim of this paper is to study the clinical features, pathogenesis and management of CUA in Peritoneal dialysis (PD) patients
We suggest the better outcomes are due to a multimodality approach with sodium thiosulfate (STS) and hyperbaric oxygen therapy (HBO)
Summary
Calcific uremic arteriolopathy (CUA), commonly referred to as calciphylaxis, is an uncommon but increasingly recognized disorder associated with high morbidity and mortality. The disorder was first reported in 1898 [1], the term calciphylaxis was coined by Selye in 1962 as a condition of systemic hypersensitivity induced by a sensitizing agent that resulted in metastatic calcification in various organs analogous to anaphylaxis [2]. It is characterized by tender plaques or nodules with violaceous discoloration associated with severe pain that is often refractory to standard analgesia [3]. The aim of this paper is to study the clinical features, pathogenesis and management of CUA in PD patients
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