Hyperbaric oxygen therapy in the treatment of skin ulcers due to calcific uraemic arteriolopathy: experience from an Australian hyperbaric unit.
نویسندگان
چکیده
INTRODUCTION Calcific uraemic arteriolopathy (CUA), also known as 'calciphylaxis', is a syndrome of ischaemic necrotic ulcers occurring in uraemic patients with end-stage renal failure. It is a debilitating condition with a high morbidity and mortality. Hyperbaric oxygen (HBO) has been used to treat such wounds for many years but evidence of its efficacy is limited. AIM We aimed to study the efficacy of HBO on the healing of problem ulcers secondary to CUA. METHOD A retrospective case review of all patients with chronic skin ulcers secondary to CUA treated at the Alfred Hospital Hyperbaric Unit from July 1997 to March 2006 (n = 20). RESULTS HBO was beneficial in eleven (55%) patients, with six of these (30%) experiencing complete resolution of their ulcers on completion of their treatment. Advancing age was identified as a predictor of a positive outcome (P = 0.02). There was no statistical correlation between the number of HBO treatments and ulcer healing. CONCLUSIONS HBO can benefit patients with chronic non-healing wounds secondary to CUA, but its precise role remains undefined.
منابع مشابه
Calcific uraemic arteriolopathy: local treatment and hyperbaric oxygen therapy.
Sir, Calcific uraemic arteriolopathy (CUA) (‘calciphylaxis’) is a rare necrotizing cutaneous abnormality which is being increasingly recognized in the dialysis population w1x. It is usually associated with secondary hyperparathyroidism in the presence of advanced renal failure and high calciumu phosphate product w2x. Treatment is difficult and often unsuccessful and is associated with a high mo...
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1Department of Nephrology and Transplantation Services, The Queen Elizabeth Hospital, University of Adelaide, Adelaide, South Australia 5011, 2Department of Medicine, University of Adelaide, North Terrace, Adelaide, South Australia 5000, 3ANZDATA Registry, The Queen Elizabeth Hospital, University of Adelaide, Adelaide, South Australia 5011 and 4Hyperbaric Unit, The Royal Adelaide Hospital, Adel...
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Calciphylaxis or calcific uremic arteriolopathy is an infrequent complication of end stage kidney disease. It is characterized by arteriolar medial calcification, thrombotic cutaneous ischemia, tissue necrosis often leading to ulceration, secondary infection and increased mortality rates. Current, multimodality treatment involves local wound care, well-controlled calcium, phosphate and parathyr...
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Calcific uremic arteriolopathy (CUA), or calciphylaxis, is an uncommon and underrecognized disease that often occurs in the setting of chronic kidney disease or end-stage renal disease. It is characterized by small-vessel calcification, although many times it is associated with normal serum levels of calcium, phosphorus, and parathyroid hormone. The lesions appear as necrotic eschars, ulceratio...
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عنوان ژورنال:
- Diving and hyperbaric medicine
دوره 38 2 شماره
صفحات -
تاریخ انتشار 2008