title: Intractable wounds caused by calcific uremic arteriolopathy treated with bisphosphonates.
abstract: BACKGROUND
  Calcific uremic arteriolopathy (calciphylaxis) is a calcification syndrome that predominantly affects relatively small vessels and is a life-threatening entity usually seen in patients with end-stage renal disease. Intractable skin necrosis sometimes causes lethal sepsis because it progresses rapidly as a result of mechanical stress.
  
  
  OBJECTIVE
  We sought to investigate the efficacy of etidronate disodium (bisphosphonates) in treating intractable ulcers occurred in a patient on hemodialysis accompanied with calcific uremic arteriolopathy.
  
  
  RESULTS
  A 53-year-old patient receiving hemodialysis with chronic renal failure accompanied with calciphylaxis had bilateral leg ulcers caused by minor trauma. The aggressive debridement worsened his skin condition as is usually seen in pyoderma gangrenosum. It eventually healed by lowering calcium-phosphorus levels with the administration of bisphosphonates and with the continuous use of sevelamer hydrochloride.
  
  
  CONCLUSIONS
  This study reporting a single case limits the interpretation of results.
  
  
  CONCLUSIONS
  Bisphosphonates may be effective in treating calciphylaxis and arteriosclerosis obliterans by reducing the formation of ectopic calcification around blood vessels.
authors.affiliation: Department of Dermatology, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Takaaki
authors.initials: T
authors.lastname: Hanafusa
authors.forename: Yuji
authors.initials: Y
authors.lastname: Yamaguchi
authors.forename: Mamori
authors.initials: M
authors.lastname: Tani
authors.forename: Noriko
authors.initials: N
authors.lastname: Umegaki
authors.forename: Yukari
authors.initials: Y
authors.lastname: Nishimura
authors.forename: Ichiro
authors.initials: I
authors.lastname: Katayama
mesh_terms: D002115:Calciphylaxis / Q000188:drug therapy* / Q000209:etiology; D012968:Etidronic Acid / Q000627:therapeutic use*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D012883:Skin Ulcer / Q000188:drug therapy / Q000209:etiology*; D016896:Treatment Outcome
chemical_list: D012968:Etidronic Acid