Calcific Uremic Arteriolopathy pada End-stage Renal Disease

Penulis

  • Iraky Mardya Rakhmadhan Dokter Umum, RSUD Kabupaten Lombok Utara, Nusa Tenggara Barat, Indonesia

DOI:

https://doi.org/10.55175/cdk.v45i3.814

Kata Kunci:

Calcific uremic arteriolopathy, end-stage renal disease, histopatologis, sodium tiosulfat

Abstrak

Calcific uremic arteriolopathy (CUA) merupakan salah satu komplikasi end-stage renal disease (ESRD), yang dapat meningkatkan morbiditas dan mortalitas. Faktor risiko CUA antara lain jenis kelamin (wanita), diabetes melitus, hiperfosfatemia, ESRD, gangguan mineral dan tulang, obesitas, warfarin, dan etnis Kaukasia. Gold standard diagnosis adalah penemuan patognomonik histopatologis spesimen biopsi kulit. Tatalaksana meliputi penanganan umum, perawatan luka, koreksi abnormalitas biokimia, sodium tiosulfat, dan beberapa terapi potensial seperti bisfosfonat, lowmolecular-weight heparin, dan agen trombolitik. CUA berpotensi fatal, diagnosis sedini mungkin dan tatalaksana yang tepat dapat memperbaiki kondisi dan memberikan hasil memuaskan.

 

Calcific uremic arteriolopathy (CUA) is one of many complications of end-stage renal disease (ESRD), causing high morbidity and mortality. Several risk factors are female gender, diabetes mellitus, hyperphosphatemia, ESRD, mineral and bone disorders, obesity, warfarin, and Caucasian. The gold standard for diagnosis is pathognomonic findings in histological skin examination. Treatment requires multidisciplinary approach involving general measures, optimal wound management, correction of biochemical abnormalities, use of sodium thiosulfate, and other potential therapeutic options such as bisphosphonate, low-molecular-weight heparin, and thrombolytic agents. CUA is potentially fatal, but early diagnosis and optimal treatment can significantly improve outcomes.

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Referensi

Yerram P, Chaudhary K. Calcific uremic arteriolopathy in end stage renal disease: Pathophysiology and management. The Ochsner Journal 2014;14:380-5.

Nigwekar SU, Wolf M, Sterns RH, Hix JK. Calciphylaxis from nonuremic causes: A systematic review. Clin J Am Soc Nephrol. 2008;3:1139-43.

Sowers KM, Hayden MR. Calcific uremic arteriolopathy pathophysiology, reactive oxygen species and therapeutic approaches. Oxidative Medicine and Cellular Longevity 2010;3(2):109-21.

Brandenburg VM, Cozzolino M, Ketteler M. Calciphylaxis: A still unmet challenge. J Nephrol. 2011;24(2):142-8.

Ross EA. Evolution of treatment strategies for calciphylaxis. Am J Nephrol. 2011;34:460-7.

Angelis M, Wong LL, Myers SA, Wong LM. Calciphylaxis in patients on hemodialysis: A prevalence study. Surgery 1997;122(6):1083-9; discussion 1089-90.

Fine A, Fontaine B. Calciphylaxis: The beginning of the end? Perit Dial Int. 2008;28(3):268-70.

Rogers NM, Teubner DJ, Coates PT. Calcific uremic arteriolopathy: Advances in pathogenesis and treatment. Semin Dial. 2007;20(2):150-7.

Giachelli CM, Jono S, Shioi A, Nishizawa Y, Mori K, Morii H. Vascular calcification and inorganic phosphate. Am J Kidney Dis. 2001;38(4 Suppl 1):34-7.

Nishizawa Y, Jono S, Ishimura E, Shioi A. Hyperphosphatemiaand vascular calcification in end-stage renal disease. J Ren Nutr. 2005;15(1):178-82.

Wilmer WA, Magro CM. Calciphylaxis: Emerging concepts in prevention, diagnosis, and treatment. Semin Dial. 2002;15(3):172-86.

Bargman JM, Skorecki K. Chronic kidney disease. In: Kasper DL, Fauci AS, Hauser SL, Longo DL, Jameson JL, Loscalzo J, editors. Harrison’s principles of internal medicine. 19thed. New York: McGraw-Hill Education; 2015. p. 1816

Diterbitkan

2018-03-01

Cara Mengutip

Rakhmadhan, I. M. (2018). Calcific Uremic Arteriolopathy pada End-stage Renal Disease. Cermin Dunia Kedokteran, 45(3), 177–180. https://doi.org/10.55175/cdk.v45i3.814

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