Calcific Uremic Arteriolopathy

Hospital Physician January 2007 31 C alcific uremic arteriolopathy (CUA), also called calciphylaxis, is a disorder of small-vessel calcification associated with the development of progressive cutaneous plaques and ulcers due to ischemia. This painful condition occurs primarily in patients with chronic kidney disease and is seen especially in those with end-stage renal disease (ESRD) who are undergoing hemodialysis or peritoneal dialysis. The estimated prevalence of CUA in ESRD patients is 4.1%.1 As the ESRD population continues to grow, this historically rare but serious disorder is likely to become more common. In a recent prospective case control study, the mortality rate at 6 months was 33% in patients with CUA who presented only with cutaneous plaques, and the mortality rate increased to 80% once ulceration developed.2 Prevention is the mainstay treatment, but once patients with CUA seek medical care, quick recognition and aggressive multidisciplinary treatment are imperative.