de Palma L, Serra F, Coletti V, Tazza L
Department of Orthopaedics, Catholic University of the Sacred Heart, School of Medicine, Rome, Italy.
J Foot Ankle Surg. 1993 Sep-Oct;32(5):526-9.
On the basis of their experience, the authors refer to complications observable at the foot level in chronic uremic patients in long-term hemodialytic treatment. These complications, termed renal osteodystrophy, are attributed to alterations in the phosphocalcium metabolism and to hyperparathyroidism. From an anatomopathologic viewpoint, they are characterized by alteration in bone tissue (osteomalacia and/or fibrous osteitis) and by soft tissue alterations. Alterations in the foot are the same as those observed in other osteoarticular regions. They consist of bone subperiosteal reabsorption of the phalanges, vascular calcifications, articular and para-articular calcifications, spontaneous disinsertion of the Achilles tendon and peripheral canalicular neuropathies specifically represented by the tarsal tunnel syndrome. Another complication of this pathology is represented by "Calciphylaxis," characterized by calcifications of the middle tunica of arteries and small arteries, by ulcerations and tissue necrosis at the foot level.
基于他们的经验，作者提及了长期血液透析治疗的慢性尿毒症患者足部可观察到的并发症。这些并发症被称为肾性骨营养不良，归因于磷钙代谢改变和甲状旁腺功能亢进。从解剖病理学角度来看，其特征是骨组织改变（骨软化症和/或纤维性骨炎）以及软组织改变。足部的改变与在其他骨关节区域观察到的相同。它们包括指骨的骨膜下骨质吸收、血管钙化、关节和关节周围钙化、跟腱自发性离断以及以跗管综合征为典型代表的周围小管性神经病变。这种病理状态的另一种并发症是“钙化防御”，其特征是中动脉和小动脉中层钙化，以及足部出现溃疡和组织坏死。
