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International Journal of Nephrology
Volume 2012 (2012), Article ID 390768, 6 pages
http://dx.doi.org/10.1155/2012/390768
Clinical Study

Calcific Uremic Arteriolopathy on Multimodal Combination Therapy: Still Unmet Goal

1Department of Endocrinology, The Townsville Hospital, 100 Angus Smith Drive, Douglas, QLD 4814, Australia
2Renal Medicine, The Townsville Hospital, 100 Angus Smith Drive, Douglas, QLD 4814, Australia
3Occupational Therapy, The Townsville Hospital, 100 Angus Smith Drive, Douglas, QLD 4814, Australia

Received 1 September 2011; Revised 18 November 2011; Accepted 3 December 2011

Academic Editor: R. Khanna

Copyright © 2012 Usman Hammawa Malabu et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Calcific uremic arteriolopathy (CUA) or calciphylaxis though generally noted for its high mortality, recent case reports have shown promising results using single agent therapies. However, it is not clear whether combination therapeutic agents will improve course of the disease. Objective. To determine clinical outcome in subjects with CUA on multimodal treatment. Methods. All patients with end-stage renal failure (ESRF) at The Townsville Hospital, Australia, from April 1, 2006, to March 31, 2011, with diagnosis of CUA were retrospectively studied. Results. Six subjects with CUA (4 females and 2 males) were on various combination therapeutic agents comprising sodium thiosulphate, hyperbaric oxygen, prednisolone, cinacalcet, and parathyroidectomy in addition to intensified haemodialysis, specialist local wound care, and antibiotics. The wounds failed to heal in 3 patients while 5 of the 6 subjects died; cause of death being sepsis in 3 and myocardial infarction in 2. Conclusion. Prognosis of CUA remains poor in spite of multimodal combination therapy. Further prospective studies on a larger population are needed to verify our findings.