title: Multimodal treatment of calcific uraemic arteriolopathy (calciphylaxis): a case series.
abstract: BACKGROUND
  This is an incident series of five dialysis patients with late-diagnosed calcific uraemic arteriolophathy (CUA), severe uncontrolled hyperparathyroidism and infected skin ulcerations.
  
  
  METHODS
  A multimodal intervention was based on wound care, antibiotics, surgical debridement, sodium thiosulphate and cinacalcet and associated with regression of skin disease in four cases after varying treatment time periods ranging from 4 to 33 months.
  
  
  RESULTS
  Multimodal treatment including sodium thiosulphate and cinacalcet was associated with very favourable local outcomes and survival. This series further confirms that the diagnosis of CUA is rarely made at the nodular, non-ulcerative phase of the disease.
  
  
  CONCLUSIONS
  This series contributes to the build-up of case series reporting on the treatment of CUA, and will hopefully serve as a basis of well-conceived comparative effectiveness studies investigating the value of the combined interventions applied so far in this severe condition.
authors.affiliation: Department of Nephrology , University of Naples , Napoli , Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Russo
authors.affiliation: Department of Nephrology , University of Naples , Napoli , Italy.
authors.forename: Alfredo
authors.initials: A
authors.lastname: Capuano
authors.affiliation: Department Nephrology , San Paolo Hospital , Milan , Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Cozzolino
authors.affiliation: Department of Nephrology , University of Naples , Napoli , Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Napolitano
authors.affiliation: Department of Surgery , University of Naples , Napoli , Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Mosella
authors.affiliation: Department of Nephrology , Second University of Naples , Napoli , Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Russo
authors.affiliation: Department of Internal Medicine , 'San Sebastiano' Hospital , Caserta , Italy.
authors.forename: Caterina
authors.initials: C
authors.lastname: Saviano
authors.affiliation: Clinical Epidemiology and Pathophysiology of Renal Diseases and Hypertension, Reggio Calabria Unit of CNR-IFC (National Research Council of Italy and Institute of Clinical Physiology), Reggio Calabria, Italy.
authors.forename: Carmine
authors.initials: C
authors.lastname: Zoccali
keywords: CUA; calcific uraemic arteriolopathy; cinacalcet; parathyroid hormone; skin ulcers