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Calcific Uremic Arteriolopathy or Calciphylaxis in a Hemodialysis Patient: Case Study and Review of the Literature

¹ Department of Nephrology, Dialysis and Kidney Transplantation of Aristide Le Dantec Hospital, Dakar, Senegal
² Department of Nephrology, Dialysis of Louis Pasteur Hospital, Chartres, France
³ Department of Nephrology, Dialysis of Louis Pasteur Hospital, Chartres, France
⁴ Department of Nephrology, Dialysis of Louis Pasteur Hospital, Chartres, France
⁵ Department of Nephrology, Dialysis of Louis Pasteur Hospital, Chartres, France
⁶ Department of Nephrology, Dialysis of Louis Pasteur Hospital, Chartres, France
⁷ Department of Nephrology, Dialysis of Louis Pasteur Hospital, Chartres, France
⁸ Department of Nephrology, Dialysis of Louis Pasteur Hospital, Chartres, France
⁹ Department of Nephrology, Dialysis of Louis Pasteur Hospital, Chartres, France
¹⁰ Department of Nephrology, Dialysis of Louis Pasteur Hospital, Chartres, France
¹¹ Department of Nephrology, Dialysis of Louis Pasteur Hospital, Chartres, France
¹² Department of Nephrology, Dialysis of Louis Pasteur Hospital, Chartres, France
¹³ Department of Nephrology, Dialysis of Louis Pasteur Hospital, Chartres, France
¹⁴ Department of Nephrology, Dialysis of Ouakam Military Hospital, Dakar, Senegal
¹⁵ Department of Nephrology, Dialysis and Kidney Transplantation of Aristide Le Dantec Hospital, Dakar, Senegal

Open Journal of Nephrology·Volume 12 (2022)·Pages 303–310·Published 28 July 2022·DOI10.4236/ojneph.2022.123031

Abstract

Calcific uremic arteriolopathy (CUA) is a rare pathology affecting 5% of dialysis patients but with a poor prognosis. It is characterized by calcification and thrombotic lesions of the microcirculation leading to hyperalgesic ischemic skin lesions. Several risk factors have been identified, mainly warfarin treatment, mineral and bone disorders (MBD), inflammation and malnutrition. In the evocative forms, the diagnosis is made based upon the physical examination finding of classic painful ulcerated lesions that are covered by a black eschar. Skin biopsy, due to the risk of aggravation and delayed healing, is only performed in case of doubt diagnosis. The therapeutic attitude due to the lack of solid randomized studies is based on expert consensus and requires a multidisciplinary approach. We report here the case of a patient with CUA revealed in the form of multiple ulcerative-necrotic skin lesions associated with pressure sores and arterial wounds.

KeywordsCalcific Uremic ArteriolopathyCalciphylaxisHemodialysis

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Calcific Uremic Arteriolopathy or Calciphylaxis in a Hemodialysis Patient: Case Study and Review of the Literature

Abstract

References (12)