Calcific Uremic Arteriolopathy: A Case Series and Review from an Inner-City Tertiary University Center in End-Stage Renal Disease Patients on Renal Replacement Therapy
Background and Objectives. Calcific uremic arteriolopathy (CUA) is a rare complication seen, especially in patients undergoing renal replacement therapy (RRT) with high morbidity and mortality. CUA treatment remains challenging. The study evaluated CUA's multifaceted treatment efficacy. Materia...
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| Format: | Article |
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Wiley
2021-01-01
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| Series: | International Journal of Nephrology |
| Online Access: | http://dx.doi.org/10.1155/2021/6661042 |
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| author | Mohamed Omer Zeenat Yousuf Bhat Nanette Fonte Nashat Imran James Sondheimer Yahya Osman‐Malik |
| author_facet | Mohamed Omer Zeenat Yousuf Bhat Nanette Fonte Nashat Imran James Sondheimer Yahya Osman‐Malik |
| author_sort | Mohamed Omer |
| collection | DOAJ |
| description | Background and Objectives. Calcific uremic arteriolopathy (CUA) is a rare complication seen, especially in patients undergoing renal replacement therapy (RRT) with high morbidity and mortality. CUA treatment remains challenging. The study evaluated CUA's multifaceted treatment efficacy. Materials and Methods. 24 patients with CUA and on RRT were evaluated at Detroit Medical Center from 2007 to 2016. Skin biopsy was used in almost all patients, along with the radiological and clinical findings. The patient’s clinical and paraclinical data were retrieved from the electronic medical records. The effect of treatment modalities and the underlying hyperparathyroidism management were compared to the clinical outcomes using appropriate statistical tests. Results. Twenty-one patients were on hemodialysis, two patients received renal transplants, and one patient was on peritoneal dialysis. Diabetes mellitus was the most prevalent cause of ESRD. The parathyroid hormone level (PTH) was elevated in 22 patients. Fifteen patients were diagnosed 2 weeks or more prior to skin lesion onset. Twenty-two and thirteen patients received sodium thiosulphate and cinacalcet, respectively. Patients with lower PTH and the calcium-phosphate product levels had a relatively better outcome of CUA. Conclusions. A multifaceted approach may play a role in treating CUA. Referral to a nephrologist may aid in the early diagnosis and prompt management of CUA. |
| format | Article |
| id | doaj-art-cbe9bd4f504a4a8fb9052049a230e00e |
| institution | Kabale University |
| issn | 2090-214X 2090-2158 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | International Journal of Nephrology |
| spelling | doaj-art-cbe9bd4f504a4a8fb9052049a230e00e2025-02-03T01:05:28ZengWileyInternational Journal of Nephrology2090-214X2090-21582021-01-01202110.1155/2021/66610426661042Calcific Uremic Arteriolopathy: A Case Series and Review from an Inner-City Tertiary University Center in End-Stage Renal Disease Patients on Renal Replacement TherapyMohamed Omer0Zeenat Yousuf Bhat1Nanette Fonte2Nashat Imran3James Sondheimer4Yahya Osman‐Malik5Division of Infectious Diseases, Mayo Clinic, Jacksonville, Florida, USADivision of Nephrology and Hypertension, Wayne State University, Detroit Medical Center, Detroit, USAAntelope Valley Nephrology Medical Group, Lancaster, California, USADivision of Nephrology and Hypertension, Wayne State University, Detroit Medical Center, Detroit, USADivision of Nephrology and Hypertension, Wayne State University, Detroit Medical Center, Detroit, USADivision of Nephrology and Hypertension, Wayne State University, Detroit Medical Center, Detroit, USABackground and Objectives. Calcific uremic arteriolopathy (CUA) is a rare complication seen, especially in patients undergoing renal replacement therapy (RRT) with high morbidity and mortality. CUA treatment remains challenging. The study evaluated CUA's multifaceted treatment efficacy. Materials and Methods. 24 patients with CUA and on RRT were evaluated at Detroit Medical Center from 2007 to 2016. Skin biopsy was used in almost all patients, along with the radiological and clinical findings. The patient’s clinical and paraclinical data were retrieved from the electronic medical records. The effect of treatment modalities and the underlying hyperparathyroidism management were compared to the clinical outcomes using appropriate statistical tests. Results. Twenty-one patients were on hemodialysis, two patients received renal transplants, and one patient was on peritoneal dialysis. Diabetes mellitus was the most prevalent cause of ESRD. The parathyroid hormone level (PTH) was elevated in 22 patients. Fifteen patients were diagnosed 2 weeks or more prior to skin lesion onset. Twenty-two and thirteen patients received sodium thiosulphate and cinacalcet, respectively. Patients with lower PTH and the calcium-phosphate product levels had a relatively better outcome of CUA. Conclusions. A multifaceted approach may play a role in treating CUA. Referral to a nephrologist may aid in the early diagnosis and prompt management of CUA.http://dx.doi.org/10.1155/2021/6661042 |
| spellingShingle | Mohamed Omer Zeenat Yousuf Bhat Nanette Fonte Nashat Imran James Sondheimer Yahya Osman‐Malik Calcific Uremic Arteriolopathy: A Case Series and Review from an Inner-City Tertiary University Center in End-Stage Renal Disease Patients on Renal Replacement Therapy International Journal of Nephrology |
| title | Calcific Uremic Arteriolopathy: A Case Series and Review from an Inner-City Tertiary University Center in End-Stage Renal Disease Patients on Renal Replacement Therapy |
| title_full | Calcific Uremic Arteriolopathy: A Case Series and Review from an Inner-City Tertiary University Center in End-Stage Renal Disease Patients on Renal Replacement Therapy |
| title_fullStr | Calcific Uremic Arteriolopathy: A Case Series and Review from an Inner-City Tertiary University Center in End-Stage Renal Disease Patients on Renal Replacement Therapy |
| title_full_unstemmed | Calcific Uremic Arteriolopathy: A Case Series and Review from an Inner-City Tertiary University Center in End-Stage Renal Disease Patients on Renal Replacement Therapy |
| title_short | Calcific Uremic Arteriolopathy: A Case Series and Review from an Inner-City Tertiary University Center in End-Stage Renal Disease Patients on Renal Replacement Therapy |
| title_sort | calcific uremic arteriolopathy a case series and review from an inner city tertiary university center in end stage renal disease patients on renal replacement therapy |
| url | http://dx.doi.org/10.1155/2021/6661042 |
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