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[Uremic arteriopathy and ischemic skin changes].

C Landerer, M A Dambacher, J J Staub

    Schweizerische Medizinische Wochenschrift
    |February 5, 1983
    PubMed
    Summary

    Uremic arteriopathy causes ischemic skin issues in dialysis patients. Managing secondary hyperparathyroidism and calcium-phosphate product is key to treatment.

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    Area of Science:

    • Nephrology
    • Dermatology
    • Pathology

    Background:

    • Uremic arteriopathy is a complication of chronic kidney disease.
    • Ischemic skin manifestations include livedo reticularis, skin infarction, and ulcerative necrosis.

    Observation:

    • A series of 6 patients with uremic arteriopathy and skin lesions were studied.
    • Patients had progressive renal failure, secondary hyperparathyroidism, and elevated calcium-x-phosphate product.
    • Vascular calcifications were evident on X-ray and skin biopsy.

    Findings:

    • Secondary hyperparathyroidism plays a crucial role in the syndrome's pathogenesis.
    • Increased plasma phosphate or calcium-x-phosphate product, calciphylaxis, or alkalinizing therapy may trigger calcium salt precipitation.
    • Therapy focuses on reducing plasma phosphate and the calcium-x-phosphate product.

    Implications:

    • Phosphate binders and low-phosphate diets are primary treatments.
    • The role of parathyroidectomy requires further investigation for unpredictable outcomes.

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