Biography
Biography: Chandandeep Takkar
Abstract
Calcific Uremic Arteriolopathy (CUA) or Calciphylaxis is a rare and frequently fatal, necrotizing skin condition, encountered mostly in patients with ESRD on dialysis. The pathologic hallmark of calciphylaxis is medial calcification, intimal fibroplasia and luminal thrombosis of cutaneous arterioles, leading to ischemic ulceration. Clinical manifestations may include nodules or plaques that often progress to ulceration, frequently complicated by sepsis and death. The term CUA has recently been proposed over calciphylaxis to more accurately reflect the pathophysiology of the disorder, however one must realize that this entity has also been reported, albeit rarely, in non –uremic patients, including those with primary hyperparathyroidism, alcoholic liver disease, malignancy and certain connective tissue disorders. The estimated prevalence of CUA in patients with ESRD is about 4%, with an annual incidence of about 1/1000 cases. The six month mortality may reach upto 80% and a multifaceted approach to treatment is warranted, with emphasis to wound and pain management, optimization of mineral and bone parameters and possible use of sodium thiosulfate.