Calcific uraemic arteriolopathy: A rare but devastating complication of end-stage renal failure

Abstract

Calcific uraemic arteriolopathy is a rare complication of end-stage renal failure. It has a grave prognosis with 1-year survival of under 50%. It occurs due to subcutaneous small vessel calcification, thrombosis, with subsequent tissue necrosis.

Calcific uraemic arteriolopathy is a rare complication of end-stage renal failure. It carries a grave prognosis with 1-year survival of under 50%. It occurs due to subcutaneous small vessel calcification, thrombosis, with subsequent tissue necrosis.

We described a case of calcific uraemic arteriolopathy in a 58-year-old man who presented with violaceous indurations over bilateral lower limbs, as well as large necrotic ulcer with adjacent eschars at the lower abdomen. Although skin biopsy is the gold standard for diagnosis, it is often avoided due to potential poor wound healing. On the other hand, in radiographs or computed tomography, fine linear or serpiginous subcutaneous calcifications are typical manifestations, which represent underlying small vessel calcifications. Radiological examinations, therefore, play an important role to establish the diagnosis.