Calcific uremic arteriolopathy in end stage renal disease: pathophysiology and management.

BACKGROUND

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.

METHODS

This review provides an overview of the pathophysiology, clinical presentation and diagnosis, and treatment of CUA.

RESULTS

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.

CONCLUSION

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.