Calcific Uremic Arteriolopathy on Multimodal Combination Therapy Still Unmet Goal英文文献资料.docVIP

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Calcific Uremic Arteriolopathy on Multimodal Combination Therapy Still Unmet Goal英文文献资料.doc

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Calcific Uremic Arteriolopathy on Multimodal Combination Therapy Still Unmet Goal英文文献资料

HindawiPublishingCorporation InternationalJournalofNephrology Volume2012,ArticleID390768,6pages doi:10.1155/2012/390768 ClinicalStudy Calci?cUremicArteriolopathyonMultimodalCombination Therapy:StillUnmetGoal UsmanHammawaMalabu, ValliManickam, GeorgeKan, SusanLynetteDoherty, 1 2 2 3 andKunwarjitSinghSangla 1 1 2 3 DepartmentofEndocrinology,TheTownsvilleHospital,100AngusSmithDrive,Douglas,QLD4814,Australia RenalMedicine,TheTownsvilleHospital,100AngusSmithDrive,Douglas,QLD4814,Australia OccupationalTherapy,TheTownsvilleHospital,100AngusSmithDrive,Douglas,QLD4814,Australia CorrespondenceshouldbeaddressedtoUsmanHammawaMalabu,umalabu@ Received1September2011;Revised18November2011;Accepted3December2011 AcademicEditor:R.Khanna Copyright?2012UsmanHammawaMalabuetal. This is an open access article distributed under the Creative Commons AttributionLicense,whichpermitsunrestricteduse,distribution,andreproductioninanymedium,providedtheoriginalworkis properlycited. Background.Calci?curemicarteriolopathy(CUA)orcalciphylaxisthoughgenerallynotedforitshighmortality,recentcasereports have shown promising results using single agent therapies. However, it is not clear whether combination therapeutic agents will improvecourseofthedisease.Objective.Todetermineclinicaloutcomeinsubjectswith CUAonmultimodaltreatment. Methods.Allpatientswithend-stagerenalfailure(ESRF)atTheTownsvilleHospital,Australia,fromApril1,2006,toMarch 31, 2011, with diagnosis of CUA were retrospectively studied. Results. Six subjects with CUA (4 females and 2 males) were onvariouscombinationtherapeuticagentscomprisingsodiumthiosulphate,hyperbaricoxygen,prednisolone,cinacalcet,and parathyroidectomyinadditiontointensi?edhaemodialysis,specialistlocalwoundcare,andantibiotics.Thewoundsfailedtoheal in3patientswhile5ofthe6subjectsdied;causeofdeathbeingsepsisin3andmyocardialinfarctionin2.Conclusion .Prognosis ofCUAremainspoorinspiteofmultimodalcombinationtherapy.Furt