Penile Calciphylaxis in End Stage Renal Disease

Calciphylaxis, better described as “Calcific uremic arteriolopathy” (CUA), involves about 1–4% of hemodialysis patients all around the world with high mortality rates. We describe a rare clinical case of CUA in peritoneal dialysis patient associated with urological disease. Penile calciphylaxis represents rare clinical complication, and an early diagnosis and multidisciplinary approach are requested. Pathogenesis is still unclear, and therapeutic approaches need more long-term clinical trials to test their efficacy and safety.

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Role of Sodium Thiosulphate in Calciphylaxis

Journal of Clinical Images and Medical Case Reports ◽

10.52768/2766-7820/1214 ◽

2021 ◽

Vol 2 (3) ◽

Author(s):

Meshal Qaiser ◽

◽

Arora Kanwardeep ◽

Keyword(s):

Adverse Effect ◽

Metabolic Acidosis ◽

End Stage Renal Disease ◽

Rare Condition ◽

Sodium Thiosulphate ◽

Calcific Uremic Arteriolopathy ◽

Stage Renal Disease ◽

End Stage

Calciphylaxis, also known as Calcific Uremic Arteriolopathy (CUA), is a rare condition often but not exclusively seen in end stage renal disease. Current literature recommends trial of Sodium Thiosulphate (STS) in all CUA patients. The long - term use of STS is limited by the adverse effect of Anion Gap Metabolic Acidosis (AGMA) which can be managed timely to maximize the benefits of STS.

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Penile calciphylaxis: a conservative approach

Annals of The Royal College of Surgeons of England ◽

10.1308/rcsann.2019.0119 ◽

2020 ◽

Vol 102 (2) ◽

pp. e36-e38 ◽

Cited By ~ 1

Author(s):

O El-Taji ◽

J Bondad ◽

S Faruqui ◽

J Bycroft

Keyword(s):

Renal Failure ◽

End Stage Renal Disease ◽

Multidisciplinary Approach ◽

Renal Dialysis ◽

Conservative Approach ◽

End Stage Renal Failure ◽

Calcific Uremic Arteriolopathy ◽

Individual Entity ◽

Stage Renal Disease ◽

End Stage

Penile calciphylaxis or calcific uremic arteriolopathy is a rare urological condition often associated with patients undergoing renal dialysis for end-stage renal disease. The majority of cases are associated with systemic calciphylaxis. The pathophysiology, diagnosis and management of penile calciphylaxis as an individual entity has brought little attention. The rates of comorbidity and mortality of these patients are often particularly high. Early diagnosis and a multidisciplinary approach are therefore essential. We report a case of penile calciphylaxis in a 59-year-old man with end-stage renal failure on haemodialysis who was successfully managed conservatively.

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Hepatitis Viruses in Heamodialysis Patients: An Added Insult to Injury?

Hepatitis Research and Treatment ◽

10.1155/2013/860514 ◽

2013 ◽

Vol 2013 ◽

pp. 1-4 ◽

Cited By ~ 3

Author(s):

Kranthi Kosaraju ◽

Sameer Singh Faujdar ◽

Aashima Singh ◽

Ravindra Prabhu

Keyword(s):

Care Center ◽

Tertiary Care ◽

Hemodialysis Patients ◽

Hepatitis Viruses ◽

Number Of Patients ◽

The Mean ◽

Stage Renal Disease ◽

End Stage ◽

Control Study

Hepatitis B (HBV) and hepatitis C (HCV) viruses are the most important causes of chronic liver disease in patients with end stage renal disease on hemodialysis. The prevalence of hepatitis infection among hemodialysis patients is high and varies between countries and between dialysis units within a single country. This case-control study was undertaken to estimate the occurrence of HBV and HCV infections in patients undergoing hemodialysis in our tertiary care center. All patients receving hemodialysis at our centre with HCV or HBV infection were included in the study. The total number of patients admitted for hemodialysis during the study period was 1710. Among these, 26 patients were positive for HBV, 19 were positive for HCV, and 2 were positive for both HCV and HBV. Mean age of the infected cases in our study was 48.63 years. Mean duration of dialysis for infected cases was 4.8 years while that of the noninfected controls was 3.18 years. The mean dialysis interval was twice a week. Interventions to reduce the occurrence of these infections are of utmost need to reduce the risk of long-term complications among hemodialysis patients.

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Assessment of arteriovenous fistulas made with the oval-shaped anastomosis technique in the end-stage renal disease patients

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v10i4.1751 ◽

2019 ◽

Vol 10 (4) ◽

pp. 3669-3673

Author(s):

Samer Makki Mohamed Al-Hakkak ◽

Firas Shaker Mahmoud Al-Faham ◽

Alaa Abood Al-Wadees ◽

Mehmet Besir Akpinar

Keyword(s):

Renal Disease ◽

End Stage Renal Disease ◽

Hemodialysis Patients ◽

Arteriovenous Fistulas ◽

Surgical Methods ◽

Stage Renal Disease ◽

End Stage ◽

Significant Health

The end-stage renal disease still holds significant health problems, getting, good, long term functioning vascular access for hemodialysis is our utmost value. Autogenous techniques are generally used for access. There are many surgical methods for getting autogenous access in hemodialysis patients. We aimed to assess the outcomes of the “oval-shaped anastomosis” technique used during the creation of arteriovenous fistulas in patients with advanced renal impairments. We randomly selected and retrospectively examined 52 patients on whom the “oval-shaped anastomosis” technique had been performed. Forty-nine (94%) patency rate in the 52 randomly selected patients on whom we used this mechanism in the first 6 months follow up. The patency and good functioning fistula created for hemodialysis is our priority in advance renal impairment. This technique has been particularly useful in stiff arteriosclerotic arteries, and it provides a more comfortable and clear anastomosis.

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Success of small-dose fractionated sodium thiosulfate in the treatment of calciphylaxis in a peritoneal dialysis patient

BMC Nephrology ◽

10.1186/s12882-021-02648-9 ◽

2022 ◽

Vol 23 (1) ◽

Author(s):

Yuan Lu ◽

Lei Shen ◽

Ling Zhou ◽

Deyu Xu

Keyword(s):

Peritoneal Dialysis ◽

Small Dose ◽

Sodium Thiosulfate ◽

Peritoneal Dialysis Patient ◽

Comprehensive Treatment ◽

Dialysis Patients ◽

Intervention Treatment ◽

Calcific Uremic Arteriolopathy ◽

Stage Renal Disease ◽

End Stage

Abstract Background Calciphylaxis, or calcific uremic arteriolopathy (CUA), is a rare, fatal disorder of microvascular calcification and thrombosis that typically affects patients with end-stage renal disease (ESRD) receiving long-term dialysis. Fewer reports describe calciphylaxis in peritoneal dialysis patients than hemodialysis patients as per a literature review. To date, there are no clear guidelines for CUA diagnosis and treatment. While sodium thiosulfate (STS) has been increasingly used for treatment in recent years, there have also been reports of severe side effects. There is no uniform standard for its usage and dosage, especially for peritoneal dialysis patients. Case presentation We present a case of a 40-year-old Chinese male patient with ESRD on peritoneal dialysis who developed calciphylaxis with severe painful cutaneous ulcers on the fingers and toes that were managed successfully for 6 months with comprehensive treatment composed mainly of small-dose fractionated sodium thiosulfate. Conclusions Our experience suggests that the treatment of calciphylaxis requires timely and multi-angle intervention. Treatment with small-dose fractionated sodium thiosulfate has proven effective and tolerated in this patient.

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Development of long-term cardiovascular disease risk prediction model for hemodialysis patients with end-stage renal disease based on nomogram

Annals of Palliative Medicine ◽

10.21037/apm-21-286 ◽

2021 ◽

Vol 10 (3) ◽

pp. 3142-3153

Author(s):

Xu You ◽

Baohuan Gu ◽

Tianlu Chen ◽

Xiangyong Li ◽

Guoxiang Xie ◽

...

Keyword(s):

Cardiovascular Disease ◽

Renal Disease ◽

Prediction Model ◽

End Stage Renal Disease ◽

Disease Risk ◽

Cardiovascular Disease Risk ◽

Hemodialysis Patients ◽

Stage Renal Disease ◽

End Stage

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Mortality in Patients on Renal Replacement Therapy and Permanent Cardiac Pacemakers

International Journal of Nephrology ◽

10.1155/2014/284172 ◽

2014 ◽

Vol 2014 ◽

pp. 1-8

Author(s):

Gabriel Vanerio ◽

Cristina García ◽

Carlota González ◽

Alejandro Ferreiro

Keyword(s):

Renal Replacement Therapy ◽

Renal Disease ◽

Replacement Therapy ◽

End Stage Renal Disease ◽

Mortality Rates ◽

Cardiac Pacemakers ◽

Propensity Analysis ◽

Stage Renal Disease ◽

End Stage

End stage renal disease is a relatively frequent disease with high mortality due to cardiac causes. Permanent pacemaker (PM) implantation rates are also very common; thus combination of both conditions is not unusual. We hypothesized that patients with chronic kidney disease with a PM would have significantly higher mortality rates compared with end stage renal disease patients without PM. Our objectives were to analyze mortality of patients on renal replacement therapy with PM. 2778 patients were on renal replacement therapy (RRT) and 110 had a PM implanted during the study period. To reduce the confounding effects of covariates, a propensity-matched score was performed. 52 PM patients and 208 non-PM matched patients were compared. 41% of the PM were implanted before entering the RRT program and 59% while on RRT. Mortality was higher in the PM group. Cardiovascular disease and infections were the most frequent causes of death. Propensity analysis showed no differences in long-term mortality between groups. We concluded that in patients on RRT and PM mortality rates are higher. Survival curves did not differ from a RRT propensity-matched group. We concluded that the presence of a PM is not an independent mortality risk factor in RRT patients.

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Sequential Bone Scintigraphy and the Evolution of Warfarin-Mediated Calcific Uremic Arteriolopathy

Case Reports in Nephrology and Dialysis ◽

10.1159/000512611 ◽

2021 ◽

pp. 78-86

Author(s):

Peter W. Santos ◽

James B. Wetmore

Keyword(s):

Bone Scintigraphy ◽

Protein Function ◽

Mineral Metabolism ◽

Matrix Gla Protein ◽

Maintenance Hemodialysis ◽

Tissue Ischemia ◽

Calcific Uremic Arteriolopathy ◽

Stage Renal Disease ◽

End Stage

Calcific uremic arteriolopathy (CUA), also known as calciphylaxis, is a complex syndrome of deranged mineral metabolism and vascular calcification leading to tissue ischemia that primarily occurs in end-stage renal disease (ESRD) patients on maintenance hemodialysis (HD). We report a case illustrating a temporal relationship between long-term warfarin anticoagulation and development of CUA in a patient with pre-dialysis chronic kidney disease (CKD) who progressed to ESRD. Serial 99mTc-methylene diphosphonate bone scintigraphy documented the evolution of metastatic CUA over a 5-month period following HD initiation. Given the temporality demonstrated here via imaging, we speculate that warfarin’s influence on vitamin K-dependent matrix Gla protein function coupled with risk factors associated with ESRD led to the development of metastatic CUA.

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