Authors
Cecilie Søndergaard, Subagini Nagarajah, Jianlin Shen, Else-Marie Bladbjerg, Alexandra Scholze
Published in
Renal failure. Volume 48. Issue 1. Pages 2710397. Epub Aug 10, 2026.
Abstract
Calcific uremic arteriolopathy (CUA) is a rare, severe condition affecting patients with chronic kidney disease (CKD). The etiology of CUA is unclear. Here, we aimed to identify factors associated with its development. We reviewed the existing evidence on its pathomechanisms and risk factors. We searched EMBASE and PubMed up to February 2026, reviewing all studies that would facilitate a comparison of CKD patients with and without CUA. Of 2374 screened publications, 35 met our inclusion criteria. The factors that consistently emerged related to CUA were decreased albumin, higher alkaline phosphatase, diabetes, increased body mass index, female sex, vitamin K antagonist (VKA) use, increased calcium phosphate product, and calcification and thrombosis in subcutaneous small arteries. Factors that appeared to be likely associated with CUA were anemia, suboptimal dialysis efficiency, peritoneal dialysis, inflammation, arterial hypertension, smoking, and hepatobiliary disease. Findings on matrix Gla protein alterations implicated in mediating VKA effects, parathyroid hormone, and hypercoagulability were ambiguous in our literature analyses. In addition, we found that a standardized system for CUA skin biopsy evaluation is lacking. In summary, our review delineates the major risk factors and pathogenic parameters associated with CUA development. Furthermore, it underscores areas in which robust data on CUA pathomechanisms are lacking.
PMID:
42572798
Bibliographic data and abstract were imported from PubMed on 10 Aug 2026.
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