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透析治疗的终末期肾病患者并发钙化防御相关的皮肤伤口。

Skin wounds associated with calciphylaxis in end-stage renal disease patients on dialysis.

机构信息

Division of Nephrology, Department of Gerontology and Metabolism, Medical Faculty of Charles University and Faculty Hospital, Hradec Králové, Czech Republic.

出版信息

Nutrition. 2010 Sep;26(9):910-4. doi: 10.1016/j.nut.2010.01.018.

Abstract

Calciphylaxis is a rare complication of chronic renal failure mostly with poor prognosis. Painful lesions on various skin surface areas are the most prominent feature of this serious disease. Subsequent infection of necrotic skin tissue is associated with the risk of sepsis. Pathophysiology is unclear, but several risk factors are known. The most important risk factor is impaired calcium-phosphate metabolism. Our paper describes two cases of different forms of calciphylaxis in patients with chronic renal failure. In the first case, pamidronate and cinacalcet were used for treatment. In the second described case, calciphylaxis was associated with secondary hyperparathyroidism and immediate subtotal parathyroidectomy was performed. Both patients were successfully treated, using systemic approach as well as dedicated local care for healing of skin wounds.

摘要

钙化防御是慢性肾衰竭的一种罕见并发症,预后大多较差。该病的最突出特征是在各种皮肤表面区域出现疼痛性病变。坏死皮肤组织随后发生感染与脓毒症风险相关。发病机制尚不清楚,但已知有一些危险因素。最重要的危险因素是钙磷代谢受损。我们的论文描述了两例慢性肾衰竭患者不同形式的钙化防御。在第一个病例中,使用了帕米膦酸和西那卡塞进行治疗。在第二个描述的病例中,钙化防御与继发性甲状旁腺功能亢进有关,立即进行了大部分甲状旁腺切除术。两名患者均通过全身治疗以及专门的皮肤伤口愈合局部护理成功治疗。

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