Liu Hongyan, Xue Jie, Yu Shanshan, Zhao Zhen, Qin Lifeng, Huang ZuZhou, Liu Zheng, Wang Haiyan
Department of Blood Transfusion, The Affiliated Hospital of Qingdao University, Qingdao, China.
Department of Blood Transfusion, The Central Hospital of Qingdao Jiaozhou, Qingdao, China.
Int Urol Nephrol. 2025 Apr 12. doi: 10.1007/s11255-025-04502-5.
Calcific uremic arteriolopathy (CUA) is a rare, but severe complication primarily affecting end-stage kidney disease (ESKD) patients on dialysis. It is characterized by calcification of small and medium-sized blood vessels, leading to ischemia and the development of painful, non-healing cutaneous ulcers. Although platelet-rich plasma (PRP), which is enriched with growth factors, has shown efficacy in treating various chronic ulcers, its use in CUA-related wounds remains poorly documented.
This case report describes the novel application of PRP therapy in managing CUA-associated skin ulcers in an ESKD patient. The aim of this study was to evaluate the safety of this treatment and document preliminary clinical outcomes.
A patient with ESKD and CUA-related non-healing skin ulcers, who showed no improvement despite medical management for secondary hyperparathyroidism, hyperphosphatemia, and hypercalcemia, experienced progressive wound healing following autologous PRP therapy. The PRP was prepared using a two-step centrifugation process and applied topically after wound debridement. Over five PRP treatment sessions at 5-day intervals within 25 days, the patient achieved complete wound closure (100% reduction from 1.5 to 0 cm), reduced exudate, and overall clinical recovery.
As an autologous product, PRP demonstrated complete wound resolution in this dialysis patient with CUA-associated refractory ulcers that were unresponsive to conventional therapies. These findings suggest that PRP may be considered as an adjunct therapy for calcific arteriolopathy, though further validation through controlled clinical trials is warranted.
钙化性尿毒症小动脉病（CUA）是一种罕见但严重的并发症，主要影响接受透析的终末期肾病（ESKD）患者。其特征是中小血管钙化，导致缺血并形成疼痛且不愈合的皮肤溃疡。尽管富含生长因子的富血小板血浆（PRP）已显示出在治疗各种慢性溃疡方面的疗效，但其在CUA相关伤口中的应用仍缺乏充分记录。
本病例报告描述了PRP疗法在治疗一名ESKD患者CUA相关皮肤溃疡中的新应用。本研究的目的是评估这种治疗方法的安全性并记录初步临床结果。
一名患有ESKD和CUA相关不愈合皮肤溃疡的患者，尽管针对继发性甲状旁腺功能亢进、高磷血症和高钙血症进行了药物治疗，但仍无改善。在接受自体PRP治疗后，伤口逐渐愈合。PRP采用两步离心法制备，并在伤口清创后局部应用。在25天内每隔5天进行5次PRP治疗，患者实现了伤口完全闭合（从1.5厘米缩小至0厘米，即100%愈合），渗出物减少，临床总体恢复。
作为一种自体产品，PRP在这名患有CUA相关难治性溃疡且对传统疗法无反应的透析患者中实现了伤口完全愈合。这些发现表明，PRP可被视为钙化性小动脉病的辅助治疗方法，不过仍需通过对照临床试验进行进一步验证。
