DOI 10.5414/CN107016

Clinical Nephrology, Volume 78 - July (61 - 63)

Maximal conservative therapy of calcific uremic ateriolopathy

Charlotte Van Noten1, Karin Janssen van Doorn1, Evert Vermander2, Sonja Vlayen3, Gert A. Verpooten1, 4, Marie-Madeleine Couttenye1, 4
Departments of 1 Nephrology-Hypertension, 2 Dermatology, 3 Nursing, Antwerp University Hospital, 4 University of Antwerp, Belgium

Abstract

We present the case of a 61-year- old female patient in long-term hemodialysis who developed calcific uremic arteriolopathy (CUA) upon administration of the oral calcimimetic agent cinacalcet for treatment of secondary hyperparathyroidism. In May 2009, the baseline serum values were parathormone (PTH) 310 pg/ml, calcium 9.1 mg/dl and phosphorous 6.9 mg/dl. Necrotic wounds in the suprapubic fat tissue were successfully treated first, by correcting the calcium phosphorous product; second, through treatment with sodium thiosulfate and third, through intensive wound care with hyperbaric oxygen therapy and vacuum-assisted closure therapy, with no need for parathyroidectomy. Multiple factors have been described to play a role in the development of CUA. Based on the findings of this case, the treatment of CUA should be aimed at correcting different causes simultaneously.

Author Details

Authors

  • Charlotte Van Noten1
  • Karin Janssen van Doorn1
  • Evert Vermander2
  • Sonja Vlayen3
  • Gert A. Verpooten1
  • 4
  • Marie-Madeleine Couttenye1
  • 4

Departments

  • Departments of
  • 1 Nephrology-Hypertension,
  • 2 Dermatology,
  • 3 Nursing, Antwerp University Hospital,
  • 4 University of Antwerp, Belgium

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