Calcific Uremic Arteriolopathy on Multimodal Combination Therapy: Still Unmet Goal

Malabu, Usman H.; Manickam, Valli; Kan, George; Doherty, Susan Lynette; Sangla, Kunwarjit S.

doi:10.1155/2012/390768

Cited by 17 publications

(12 citation statements)

References 20 publications

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“…12,15 Regarding the prevalence of LLAs in ESRF patients, on dialysis that has been recorded has a wide distribution from as low as 1.72% in Japan 16 to as high as 13.4% in Canada, 17 there is no recorded prevalence from the Australian continent even though Australian data suggests high rates of CVD, DM and ESRF amongst the indigenous population. 18,19 Indigenous Australians have been found to have a 38 times higher risk for LLA secondary to DM as compared to their non-indigenous counterparts. 20 However, this data does not account for ESRF or dialysis therapy.…”

Section: Introductionmentioning

confidence: 99%

Non-traumatic lower limb amputation in patients with end-stage renal failure on dialysis: an Australian perspective

et al. 2016

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Background: End-stage renal failure (ESRF) and dialysis have been identified as a risk factor for lower limb amputations (LLAs). High rate of ESRF amongst the Australian population has been reported, however till date no study has been published identifying magnitude and risk factors of LLA in subjects on renal dialysis. Objective: The study aims to document trends in the prevalence and identify risk factors of nontraumatic LLA in Australian patients on dialysis. Methods: A retrospective review of all patients (218) ] p¼ 0.01). 75% of the amputees had aboriginal heritage. We also identified higher HbA1c and CRP levels as well as low serum albumin, hemoglobin and vitamin D levels to have a strong association with LLAs (p < 0.05). Conclusion: There is high prevalence of LLAs amongst Australian indigenous patients with diabetes on dialysis in North Queensland. Other strongly associated risk factors include history of foot ulceration, foot deformity and peripheral neuropathy as well as high HbA1c levels and low serum albumin levels.

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Section: Introductionmentioning

confidence: 99%

Non-traumatic lower limb amputation in patients with end-stage renal failure on dialysis: an Australian perspective

et al. 2016

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“…Although the exact mechanism of action is unknown (16,17), several case reports and small case series have been published on STS administration for CUA (17). However, published data on STS have been mixed, with some demonstrating beneficial effects (18)(19)(20) and others showing no benefit (21,22). Adding complexity to the issue is the possibility of publication bias.…”

Section: Introductionmentioning

confidence: 99%

Sodium Thiosulfate Therapy for Calcific Uremic Arteriolopathy

Nigwekar

Brunelli

Meade

et al. 2013

Clinical Journal of the American Society of Nephrology

185

136

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SummaryBackground and objective Calcific uremic arteriolopathy (CUA) is an often fatal condition with no effective treatment. Multiple case reports and case series have described intravenous sodium thiosulfate (STS) administration in CUA, but no studies have systematically evaluated this treatment.Design, setting, participants, & measurements This study included 172 patients undergoing maintenance hemodialysis who had CUA and were treated with STS between August 2006 and June 2009 at Fresenius Medical Care North America. Of these, 85% completed STS therapy. Clinical, laboratory, and mortality data were abstracted from clinical information systems. Responses to survey questionnaires sent to treating physicians regarding patient-level outcomes were available for 53 patients. Effect on CUA lesions and mortality were summarized as CUA outcomes. Relevant laboratory measures, weight (using pairwise comparisons of values before, during, and after STS), and adverse events were summarized as safety parameters.Results Mean age of the cohort was 55 years, and 74% of patients were women. Median STS dose was 25 g, and median number of doses was 38. Among surveyed patients, CUA completely resolved in 26.4%, markedly improved in 18.9%, improved in 28.3%, and did not improve in 5.7%; in the remaining patients (20.8%), the response was unknown. One-year mortality in patients treated with STS was 35%. Adverse events, laboratory abnormalities, and weight-related changes were mild. Significant reductions in serum phosphorous (P=0.02) and parathyroid hormone (P=0.01) were noted during STS treatment in patients who completed the therapy.Conclusions Although conclusive evidence regarding its efficacy is lacking, a majority of patients who received STS demonstrated clinical improvement in this study.

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“…Previous reports of the use of hyperbaric oxygen in calciphylaxis have been limited to small series or case reports (Table ) . In these reports, patients have often failed to respond to conventional therapies including wound debridement, antibiotic therapy and parathyroidectomy and had complete wound healing with HBOT.…”

Section: Discussionmentioning

confidence: 99%

Hyperbaric oxygen in the treatment of calciphylaxis: A case series and literature review

Devaney

Ooi

et al. 2015

Nephrology

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Calcific Uremic Arteriolopathy on Multimodal Combination Therapy: Still Unmet Goal

Cited by 17 publications

References 20 publications

Non-traumatic lower limb amputation in patients with end-stage renal failure on dialysis: an Australian perspective

Non-traumatic lower limb amputation in patients with end-stage renal failure on dialysis: an Australian perspective

Sodium Thiosulfate Therapy for Calcific Uremic Arteriolopathy

Hyperbaric oxygen in the treatment of calciphylaxis: A case series and literature review

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