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Clin Kidney J. 2016 Feb;9(1):108-12. doi: 10.1093/ckj/sfv120. Epub 2015 Nov 20.

Multimodal treatment of calcific uraemic arteriolopathy (calciphylaxis): a case series.

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Department of Nephrology , University of Naples , Napoli , Italy.
Department Nephrology , San Paolo Hospital , Milan , Italy.
Department of Surgery , University of Naples , Napoli , Italy.
Department of Nephrology , Second University of Naples , Napoli , Italy.
Department of Internal Medicine , 'San Sebastiano' Hospital , Caserta , Italy.
Clinical Epidemiology and Pathophysiology of Renal Diseases and Hypertension, Reggio Calabria Unit of CNR-IFC (National Research Council of Italy and Institute of Clinical Physiology), Reggio Calabria, Italy.



This is an incident series of five dialysis patients with late-diagnosed calcific uraemic arteriolophathy (CUA), severe uncontrolled hyperparathyroidism and infected skin ulcerations.


A multimodal intervention was based on wound care, antibiotics, surgical debridement, sodium thiosulphate and cinacalcet and associated with regression of skin disease in four cases after varying treatment time periods ranging from 4 to 33 months.


Multimodal treatment including sodium thiosulphate and cinacalcet was associated with very favourable local outcomes and survival. This series further confirms that the diagnosis of CUA is rarely made at the nodular, non-ulcerative phase of the disease.


This series contributes to the build-up of case series reporting on the treatment of CUA, and will hopefully serve as a basis of well-conceived comparative effectiveness studies investigating the value of the combined interventions applied so far in this severe condition.


CUA; calcific uraemic arteriolopathy; cinacalcet; parathyroid hormone; skin ulcers

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