Yerram Preethi, Chaudhary Kunal
Division of Nephrology, Department of Internal Medicine, University of Missouri School of Medicine, Columbia, MO.
Division of Nephrology, Department of Internal Medicine, University of Missouri School of Medicine, Columbia, MO ; Nephrology Section, Harry S. Truman Memorial Veterans Hospital, Columbia, MO.
Ochsner J. 2014 Fall;14(3):380-5.
Calcific uremic arteriolopathy (CUA), a debilitating condition with high morbidity and mortality, is most commonly seen in patients with kidney disease. The pathophysiology of CUA is multifactorial, leading to a disruption in the balance between factors that promote and those that inhibit calcification, although the exact pathophysiological mechanisms of CUA remain to be elucidated.
This review provides an overview of the pathophysiology, clinical presentation and diagnosis, and treatment of CUA.
Diagnosis of CUA requires a high degree of suspicion; skin biopsy with histological examination remains the gold standard to confirm the diagnosis. Treatment of CUA requires a multidisciplinary approach.
With a high degree of clinical suspicion and early diagnosis, an aggressive multifactorial treatment approach involving optimal wound management, minimization/avoidance of risk factors and precipitating causes, and correction of calcium-phosphorus abnormalities can significantly improve patient outcomes.
钙化性尿毒症性小动脉病（CUA）是一种发病率和死亡率都很高的使人衰弱的疾病，最常见于肾病患者。CUA的病理生理学是多因素的，导致促进钙化和抑制钙化的因素之间的平衡被破坏，尽管CUA的确切病理生理机制仍有待阐明。
本综述概述了CUA的病理生理学、临床表现与诊断以及治疗。
CUA的诊断需要高度怀疑；皮肤活检及组织学检查仍是确诊的金标准。CUA的治疗需要多学科方法。
有了高度的临床怀疑和早期诊断，积极的多因素治疗方法，包括最佳伤口处理、最小化/避免危险因素和诱发原因以及纠正钙磷异常，可显著改善患者预后。
