Table of Contents Author Guidelines Submit a Manuscript
Table of Contents Alerts

To receive news and publication updates for International Journal of Nephrology, enter your email address in the box below.

International Journal of Nephrology
Volume 2011 (2011), Article ID 982854, 9 pages
http://dx.doi.org/10.4061/2011/982854
Review Article

Calcific Uremic Arteriolopathy in Peritoneal Dialysis Populations

Nicholas New,1 Janaki Mohandas,1 George T. John,1 Sharad Ratanjee,1 Helen Healy,1 Leo Francis,2 and Dwarakanathan Ranganathan1,3

1Department of Nephrology, Royal Brisbane and Women’s Hospital, Queensland Health, Butterfield Street, Herston, QLD 4029, Australia
2Department of Anatomical Pathology, Royal Brisbane and Women’s Hospital, Queensland Health, Butterfield Street, Herston, QLD 4029, Australia
3School of Medicine, The University of Queensland, Brisbane, QLD 4027, Australia

Received 1 March 2011; Revised 11 April 2011; Accepted 14 April 2011

Academic Editor: Hulya Taskapan

Copyright © 2011 Nicholas New 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.

Linked References

  1. J. H. Bryant and W. H. White, “A case of calcification of the arteries and obliterative endarterities associated with hydronephrosis in a child age six months,” Guys Hospital Report, vol. 55: 1719, 1898. View at Google Scholar
  2. H. Selye, Calciphylaxis, University of Chicago Press, Chicago, Ill, USA, 1962.
  3. N. M. Rogers, D. J. O. Teubner, and P. T. H. Coates, “Calcific uremic arteriolopathy: advances in pathogenesis and treatment,” Seminars in Dialysis, vol. 20, no. 2, pp. 150–157, 2007. View at Publisher · View at Google Scholar · View at Scopus
  4. R. H. Weenig, L. D. Sewell, M. D. P. Davis, J. T. McCarthy, and M. R. Pittelkow, “Calciphylaxis: natural history, risk factor analysis, and outcome,” Journal of the American Academy of Dermatology, vol. 56, no. 4, pp. 569–579, 2007. View at Publisher · View at Google Scholar · View at Scopus
  5. W. A. Wilmer and C. M. Magro, “Calciphylaxis: rmerging concepts in prevention, diagnosis, and treatment,” Seminars in Dialysis, vol. 15, no. 3, pp. 172–186, 2002. View at Publisher · View at Google Scholar · View at Scopus
  6. R. Russell, M. A. Brookshire, M. Zekonis, and S. M. Moe, “Distal calcific uremic arteriolopathy in a hemodialysis patient responds to lowering of Ca × P product and aggressive wound care,” Clinical Nephrology, vol. 58, no. 3, pp. 238–243, 2002. View at Google Scholar · View at Scopus
  7. A. R. Mazhar, R. J. Johnson, D. Gillen et al., “Risk factors and mortality associated with calciphylaxis in end-stage renal disease,” Kidney International, vol. 60, no. 1, pp. 324–332, 2001. View at Publisher · View at Google Scholar · View at Scopus
  8. R. L. Mehta, G. Scott, J. A. Sloand, and C. W. Francis, “Skin necrosis associated with acquired protein C deficiency in patients with renal failure and calciphylaxis,” American Journal of Medicine, vol. 88, no. 3, pp. 252–257, 1990. View at Publisher · View at Google Scholar · View at Scopus
  9. S. U. Nigwekar, M. Wolf, R. H. Sterns, and J. K. Hix, “Calciphylaxis from nonuremic causes: a systematic review,” Clinical Journal of the American Society of Nephrology, vol. 3, no. 4, pp. 1139–1143, 2008. View at Publisher · View at Google Scholar
  10. A. Fine and J. Zacharias, “Calciphylaxis is usually nonulcerating: risk factors, outcomes, and therapy,” Kidney International, vol. 61, no. 6, pp. 2210–2217, 2002. View at Google Scholar
  11. J. M. Zacharias, B. Fontaine, and A. Fine, “Calcium use increases risk of calciphylaxis: a case-control study,” Peritoneal Dialysis International, vol. 19, no. 3, pp. 248–252, 1999. View at Google Scholar · View at Scopus
  12. A. Fine and B. Fontaine, “Calciphylaxis: the beginning of the end?” Peritoneal Dialysis International, vol. 28, no. 3, pp. 268–270, 2008. View at Google Scholar
  13. J. S. Cicone, J. B. Petronis, C. D. Embert, and D. A. Spector, “Successful treatment of calciphylaxis with intravenous sodium thiosulfate,” American Journal of Kidney Diseases, vol. 43, no. 6, pp. 1104–1108, 2004. View at Google Scholar · View at Scopus
  14. D. Mataic and B. Bastani, “Intraperitoneal sodium thiosulfate for the treatment of calciphylaxis,” Renal Failure, vol. 28, no. 4, pp. 361–363, 2006. View at Publisher · View at Google Scholar · View at Scopus
  15. O. H.D. Thang, E. H. Jaspars, and P. M. ter Wee, “Necrotizing mastitis caused by calciphylaxis,” Nephrology Dialysis Transplantation, vol. 21, no. 7, pp. 2020–2021, 2006. View at Publisher · View at Google Scholar
  16. N. Amin, E. Gonzalez, M. Lieber, I. B. Salusky, and J. J. Zaritsky, “Successful treatment of calcific uremic arteriolopathy in a pediatric dialysis patient,” Pediatric Nephrology, vol. 25, no. 2, pp. 357–362, 2010. View at Publisher · View at Google Scholar · View at Scopus
  17. E. Daudén and M. J. Oñate, “Calciphylaxis,” Dermatologic Clinics, vol. 26, no. 4, pp. 557–568, 2008. View at Publisher · View at Google Scholar · View at Scopus
  18. N. M. Rogers and P. T. H. Coates, “Calcific uraemic arteriolopathy: an update,” Current Opinion in Nephrology and Hypertension, vol. 17, no. 6, pp. 629–634, 2008. View at Publisher · View at Google Scholar · View at Scopus
  19. W. Bleibel, B. Hazar, and R. Herman, “A case report comparing various radiological tests in the diagnosis of calcific uremic arteriolopathy,” American Journal of Kidney Diseases, vol. 48, no. 4, pp. 659–661, 2006. View at Publisher · View at Google Scholar · View at Scopus
  20. S. H. Sakr, E. B. Russell, and H. E. Jasin, “Systematic lupus erythematosus and calciphylaxis,” Journal of Rheumatology, vol. 31, no. 9, pp. 1851–1853, 2004. View at Google Scholar · View at Scopus
  21. N. Igaki, R. Moriguchi, Y. Hirota et al., “Calciphylaxis in a patient with end-stage renal disease secondary to systemic lupus erythematosus associated with acral gangrene and mesenteric ischemia,” Internal Medicine, vol. 40, no. 12, pp. 1232–1237, 2001. View at Google Scholar · View at Scopus
  22. M. Angelis, L. L. Wong, S. A. Myers, and L. M. Wong, “Calciphylaxis in patients on hemodialysis: a prevalence study,” Surgery, vol. 122, no. 6, pp. 1083–1090, 1997. View at Publisher · View at Google Scholar
  23. A. J. Bleyer, M. Choi, B. Igwemezie, E. De La Torre, and W. L. White, “A case control study of proximal calciphylaxis,” American Journal of Kidney Diseases, vol. 32, no. 3, pp. 376–383, 1998. View at Google Scholar · View at Scopus
  24. T. Coates, G. S. Kirkland, R. B. Dymock et al., “Cutaneous necrosis from calcific uremic arteriolopathy,” American Journal of Kidney Diseases, vol. 32, no. 3, pp. 384–391, 1998. View at Google Scholar · View at Scopus
  25. C. M. Giachelli, M. Y. Speer, X. Li, R. M. Rajachar, and H. Yang, “Regulation of vascular calcification: roles of phosphate and osteopontin,” Circulation Research, vol. 96, no. 7, pp. 717–722, 2005. View at Publisher · View at Google Scholar · View at Scopus
  26. S. Jono, M. D. McKee, C. E. Murry et al., “Phosphate regulation of vascular smooth muscle cell calcification,” Circulation research, vol. 87, no. 7, pp. E10–E17, 2000. View at Google Scholar · View at Scopus
  27. H. Yang, G. Curinga, and C. M. Giachelli, “Elevated extracellular calcium levels induce smooth muscle cell matrix mineralization in vitro,” Kidney International, vol. 66, no. 6, pp. 2293–2299, 2004. View at Publisher · View at Google Scholar · View at Scopus
  28. R. H. Weenig, “Pathogenesis of calciphylaxis: Hans Selye to nuclear factor κ-B,” Journal of the American Academy of Dermatology, vol. 58, no. 3, pp. 458–471, 2008. View at Publisher · View at Google Scholar · View at Scopus
  29. A. Y.-M. Wang, “Vascular and other tissue calcification in peritoneal dialysis patients,” Peritoneal Dialysis International, vol. 29, supplement 2, pp. S9–S14, 2009. View at Google Scholar
  30. M. Ketteler, P. Bongartz, R. Westenfeld et al., “Association of low fetuin-A (AHSG) concentrations in serum with cardiovascular mortality in patients on dialysis: a cross-sectional study,” Lancet, vol. 361, no. 9360, pp. 827–833, 2003. View at Publisher · View at Google Scholar · View at Scopus
  31. G. Luo, P. Ducy, M. D. McKee et al., “Spontaneous calcification of arteries and cartilage in mice lacking matrix GLA protien,” Nature, vol. 386, no. 6620, pp. 78–81, 1997. View at Publisher · View at Google Scholar · View at Scopus
  32. M. M. H. Hermans, C. Vermeer, J. P. Kooman et al., “Undercarboxylated matrix GLA protein levels are decreased in dialysis patients and related to parameters of calcium-phosphate metabolism and aortic augmentation index,” Blood Purification, vol. 25, no. 5-6, pp. 395–401, 2008. View at Publisher · View at Google Scholar
  33. M. Farah, R. I. Crawford, A. Levin, and C. Chan Yan, “Calciphylaxis in the current era: emerging ‘ironic’ features?” Nephrology Dialysis Transplantation, vol. 26, no. 1, pp. 191–195, 2011. View at Publisher · View at Google Scholar
  34. S. Ahmed, K. D. Oneill, A. F. Hood, A. P. Evan, and S. M. Moe, “Calciphylaxis is associated with hyperphosphatemia and increased osteopontin expression by vascular smooth muscle cells,” American Journal of Kidney Diseases, vol. 37, no. 6, pp. 1267–1276, 2001. View at Google Scholar · View at Scopus
  35. A. S. Kang, J. T. McCarthy, C. Rowland et al., “Is calciphylaxis best treated surgically or medically?” Surgery, vol. 128, no. 6, pp. 967–972, 2000. View at Google Scholar · View at Scopus
  36. K. E. Chan, J. M. Lazarus, R. Thadhani, and R. M. Hakim, “Anticoagulant and antiplatelet usage associates with mortality among hemodialysis patients,” Journal of the American Society of Nephrology, vol. 20, no. 4, pp. 872–881, 2009. View at Publisher · View at Google Scholar · View at Scopus
  37. R. Levy, “Potential treatment of calciphylaxis with vitamin K2: comment on the article by Jacobs-Kosmin and DeHoratius,” Arthritis Care and Research, vol. 57, no. 8, pp. 1575–1576, 2007. View at Publisher · View at Google Scholar
  38. M. R. Chan, A. S. Yevzlin, M. Hinshaw, and J. B. Jaffery, “Calciphylaxis responsive to lanthanum carbonate (FOSRENOL) therapy,” Wisconsin Medical Journal, vol. 107, no. 7, pp. 335–338, 2008. View at Google Scholar
  39. F. Llach, “The evolving pattern of calciphylaxis: therapeutic considerations,” Nephrology Dialysis Transplantation, vol. 16, no. 3, pp. 448–451, 2001. View at Google Scholar · View at Scopus
  40. A. Duffy, M. Schurr, T. Warner, and H. Chen, “Long-term outcomes in patients with calciphylaxis from hyperparathyroidism,” Annals of Surgical Oncology, vol. 13, no. 1, pp. 96–102, 2006. View at Publisher · View at Google Scholar · View at Scopus
  41. N. Velasco, M. S. MacGregor, A. Innes, and I. G. MacKay, “Successful treatment of calciphylaxis with cinacalcet—an alternative to parathyroidectomy?” Nephrology Dialysis Transplantation, vol. 21, no. 7, pp. 1999–2004, 2006. View at Publisher · View at Google Scholar · View at Scopus
  42. G. Elder, “The CARI guidelines. Biochemical and haematological targets: Parathyroid hormone,” 2006, http://www.cari.org.au/.
  43. C. G. Musso, P. Enz, F. Vidal et al., “Oral sodium thiosulfate solution as a secondary preventive treatment for calciphylaxis in dialysis patients,” Saudi Journal of Kidney Diseases and Transplantation, vol. 19, no. 5, pp. 820–821, 2008. View at Google Scholar · View at Scopus
  44. M. R. Hayden and D. J. A. Goldsmith, “Sodium thiosulfate: new hope for the treatment of calciphylaxis,” Seminars in Dialysis, vol. 23, no. 3, pp. 258–262, 2010. View at Publisher · View at Google Scholar
  45. M. Brucculeri, J. Cheigh, G. Bauer, and D. Serur, “Long-term intravenous sodium thiosulfate in the treatment of a patient with calciphylaxis,” Seminars in Dialysis, vol. 18, no. 5, pp. 431–434, 2005. View at Publisher · View at Google Scholar · View at Scopus
  46. M. J. Courtney and N. Pannu, “Calcific uremic arteriolopathy should be treated conservatively,” Seminars in Dialysis, vol. 23, no. 1, pp. 34–37, 2010. View at Publisher · View at Google Scholar · View at Scopus
  47. K. Subramaniam, H. Wallace, R. Sinniah, and B. Saker, “Complete resolution of recurrent calciphylaxis with long-term intravenous sodium thiosulfate,” Australasian Journal of Dermatology, vol. 49, no. 1, pp. 30–34, 2008. View at Publisher · View at Google Scholar · View at Scopus
  48. N. M. Rogers and P. T. H. Coates, “Calcific uremic arteriolopathy—the argument for hyperbaric oxygen and sodium thiosulfate,” Seminars in Dialysis, vol. 23, no. 1, pp. 38–42, 2010. View at Publisher · View at Google Scholar · View at Scopus
  49. C. Basile, A. Montanaro, M. Masi, G. Pati, P. De Maio, and A. Gismondi, “Hyperbaric oxygen therapy for calcific uremic arteriolopathy: a case series,” Journal of Nephrology, vol. 15, no. 6, pp. 676–680, 2002. View at Google Scholar · View at Scopus
  50. T. Podymow, C. Wherrett, and K. D. Burns, “Hyperbaric oxygen in the treatment of calciphylaxis: a case series,” Nephrology Dialysis Transplantation, vol. 16, no. 11, pp. 2176–2180, 2001. View at Google Scholar · View at Scopus
  51. R. M. Leach, P. J. Rees, and P. Wilmshurst, “ABC of oxygen: hyperbaric oxygen therapy,” British Medical Journal, vol. 317, no. 7166, pp. 1140–1143, 1998. View at Google Scholar · View at Scopus
  52. T. Coates, G. S. Kirkland, R. B. Dymock et al., “Cutaneous necrosis from calcific uremic arteriolopathy,” American Journal of Kidney Diseases, vol. 32, no. 3, pp. 384–391, 1998. View at Google Scholar · View at Scopus
  53. P. Monney, Q. V. Nguyen, H. Perroud, and E. Descombes, “Rapid improvement of calciphylaxis after intravenous pamidronate therapy in a patient with chronic renal failure,” Nephrology Dialysis Transplantation, vol. 19, no. 8, pp. 2130–2132, 2004. View at Publisher · View at Google Scholar · View at Scopus