nidНефрология и диализNephrology and Dialysis1680-44222618-9801Российское диализное обществоnid-529Research ArticleНАБЛЮДЕНИЯ ИЗ ПРАКТИКИCASE REPORTSКальцифицирующая уремическая артериолопатия (кальцифилаксия) Обзор литературы и собственное наблюдениеCalcific uremic arteriolopathy (calciphylaxis) Review and case descriptionЕгшатянЛ. В.EgshatyanL. V.lilit.egshatyan@yandex.ruРожинскаяЛ. Я.RozhinskayaL. Ya.noemail@neicon.ruГБОУ ВПО «Московский государственный медико-стоматологический университет им. А.И. Евдокимова»; ФГБУ ГНИЦ «Профилактической Медицины» Министерства здравоохранения Российской ФедерацииРоссияA.I. Evdokimov Moscow State University of Medicine and Dentistry; Federal State Institution «National Research Center for Preventive Medicine» of the Ministry Healthcare of the Russian FederationRussian FederationФГБУ «Эндокринологический научный центр» Министерства здравоохранения Российской ФедерацииРоссияFederal State Institution «Endocrinologic Scientific Center» of the Ministry Healthcare of the Russian FederationRussian Federation201529082024174478485Copyright © Егшатян Л.В., Рожинская Л.Я., 20242024Егшатян Л.В., Рожинская Л.Я.Egshatyan L.V., Rozhinskaya L.Y.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.nephro.ru/jour/article/view/529

Кальцифицирующая уремическая артериолопатия (КУА), ранее известная как кальцифилаксия, является редким и серьезным проявлением внескелетной кальцификации у пациентов с терминальной стадией хронической болезни почек. КУА характеризуется тяжелым течением и проявляется системной кальцификацией кожных артериол, приводящей к ишемии и подкожному некрозу тканей. До настоящего времени не установлен точный патогенез заболевания, также нет никаких специфических лабораторных маркеров диагностики. Лечение подразумевает мультиинтервенционный подход (адекватный диализ; обработка раны; медикаментозная терапия; отмена препаратов, относящихся к факторам риска развития или ухудшения течения КУА; соблюдение строгой гипофосфатной диеты), который показывает высокую эффективность и позволяет сократить смертность. Однако оптимальные дозы препаратов и продолжительность терапии нуждаются в дальнейшем изучении. В данной статье мы представляем обзор современной литературы, также результат собственного наблюдения и комплексного подхода к лечению КУА у 64-летней пациентки с хронической болезнью почек 5 стадии с тяжелым течением вторичного гиперпаратиреоза, с высокой степенью коморбидности, находящейся на лечении программным гемодиализом. На фоне многокомпонентной терапии и комплексного подхода к проблеме был получен положительный эффект.

Calcific uremic arteriolopathy (CUA), previously also called calciphylaxis, is one of the several types of extra-osseous calcification and a rare and devastating disorder which most often occurs in patients with severe renal disease. CUA is a serious disorder characterized by systemic medial calcification of the arterioles that leads to ischemia and subcutaneous necrosis. The pathogenesis of CUA is poorly understood, and the optimal treatment is not known. A multi-interventional strategy (adequate dialysis, surgical debridement and wound care, hypophosphatic diet, drug treatment) is likely to be more effective than any single therapy and allows one to reduce mortality. Here we present a case of a 64-year-old female with the end-stage renal disease on chronic hemodialysis and with several secondary hyperparathyroidism (extensive two ulcers on the left leg with necrotic eschars). Our case study shows that multi-interventional strategy is likely to be more effective in treatment of CUA in patients with the end-stage renal disease on hemodialysis with several secondary hyperparathyroidism.

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The authors declare that there are no conflicts of interest present.