Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Sep;36(7):1991-1999.
doi: 10.1007/s40620-023-01707-8. Epub 2023 Jul 19.

Cutaneous vascular calcifications in patients with chronic kidney disease and calcific uremic arteriolopathy: a cross-sectional study

Anne Kristine Røndbjerg  1   2   3 , Mette Gyldenløve  4 , Dorrit Krustrup  5 , Marianne Rix  2 , Ilse Vejborg  6 , Lars Lonn  7   8 , Niklas Rye Jørgensen  9   8 , Andreas Pasch  10   11 , Lone Skov  4   8 , Ditte Hansen  12   13   14
Affiliations

Cutaneous vascular calcifications in patients with chronic kidney disease and calcific uremic arteriolopathy: a cross-sectional study

Anne Kristine Røndbjerg et al. J Nephrol. 2023 Sep.

Abstract

Introduction: Calcific uremic arteriolopathy is a life-threatening cutaneous condition in patients with chronic kidney disease. Often, clinical diagnosis is accompanied by histopathologic evaluations demonstrating vascular calcium deposits. We aimed to investigate the presence of cutaneous calcifications in non-lesional tissue in patients with chronic kidney disease, and the relation to systemic vascular calcification.

Methods: We investigated the presence of cutaneous vascular calcifications in non-lesional skin biopsies from patients with current or previous calcific uremic arteriolopathy and patients with different stages of chronic kidney disease without calcific uremic arteriolopathy, and explored their association with vascular calcification in other vascular beds. Systemic vascular calcification was examined by mammography and lumbar X-ray.

Results: Thirty-nine adults were enrolled (current or previous calcific uremic arteriolopathy, n = 9; end-stage chronic kidney disease, n = 12; chronic kidney disease stage 3b-4, n = 12; healthy controls, n = 6). All calcific uremic arteriolopathy patients had end-stage kidney disease. Cutaneous vascular calcifications were not present in any of the non-lesional skin punch biopsies. Breast arterial calcification was demonstrated in patients with calcific uremic arteriolopathy (75%) and chronic kidney disease (end-stage 67% and stage 3b-4 25%, respectively), but in none of the controls. All chronic kidney disease patients had systemic calcification on lumbar X-ray (median score 21, 22, and 15 in patients with calcific uremic arteriolopathy, end-stage kidney disease and chronic kidney disease stage 3b-4). The serum calcification propensity was significantly different between groups.

Discussion: Despite a high burden of systemic vascular calcification, cutaneous calcium deposits in non-lesional tissue could not be demonstrated histopathologically in patients with chronic kidney disease (with or without current or previous calcific uremic arteriolopathy). Further studies to determine whether these findings are representative or attributed to other factors are warranted.

Keywords: Calcific uremic arteriolopathy; Calcification propensity; Calcifications; Chronic kidney disease.

PubMed Disclaimer

Conflict of interest statement

A Pasch is an employee and stockholder of Calciscon AG, Biel, Switzerland, which commercializes the T50 test. DH, MD, DK, MR, IV, LL, NJ, LS, DH have no competing interests.

Figures

Fig. 1
Fig. 1
Lesional and non-lesional skin biopsies
Fig. 2
Fig. 2
Prevalence of breast arterial calcifications and abdominal aortic calcifications between groups
Fig. 3
Fig. 3
Levels of T50, Fetuin A and dp-ucMGP between groups
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Nigwekar SU, Thadhani R, Brandenburg VM. Calciphylaxis. N Engl J Med. 2018;378:1704–1714. doi: 10.1056/NEJMra1505292. - DOI - PubMed
    1. Chaudet KM, Dutta P, Nigwekar SU, Nazarian RM. Calciphylaxis-associated cutaneous vascular calcification in noncalciphylaxis patients. Am J Dermatopathol. 2020;42:557–563. doi: 10.1097/DAD.0000000000001519. - DOI - PubMed
    1. Ellis CL, O'Neill WC. Questionable specificity of histologic findings in calcific uremic arteriolopathy. Kidney Int. 2018;94:390–395. doi: 10.1016/j.kint.2018.03.016. - DOI - PubMed
    1. Ruderman I, Hewitson TD, Smith ER, et al. Vascular calcification in skin and subcutaneous tissue in patients with chronic and end-stage kidney disease. BMC Nephrol. 2020;21:279. doi: 10.1186/s12882-020-01928-0. - DOI - PMC - PubMed
    1. Brandenburg VM, Evenepoel P, Floege J, et al. Lack of evidence does not justify neglect: how can we address unmet medical needs in calciphylaxis? Nephrol Dial Transplant. 2016;31:1211–1219. doi: 10.1093/ndt/gfw025. - DOI - PubMed

Publication types