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Saudi Journal of Kidney Diseases and Transplantation
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CASE REPORT Table of Contents   
Year : 2016  |  Volume : 27  |  Issue : 6  |  Page : 1265-1269
Penile calcific uremic arteriolopathy occurring postparathyroidectomy in a hemodialysis patient


1 Department of Physiology, College of Medicine, King Khalid University, Abha, Saudi Arabia
2 Department of Nephrology, Aseer Central Hospital, Ministry of Health, Abha, Saudi Arabia
3 Department of Nephrology Department, College of Medicine, King Khalid University, Abha, Saudi Arabia

Correspondence Address:
Salah Omar Bashir
Department of Physiology, College of Medicine, King Khalid University, Abha
Saudi Arabia
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DOI: 10.4103/1319-2442.194685

PMID: 27900978

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Calcific uremic arteriolopathy (CUA), also known as calciphylaxis, is a rare condition most frequently seen in patients with advanced chronic kidney disease. The clinical picture is characterized by painful skin lesions and ulcerations. The underlying pathology is medial calcification and intimal proliferation with microthrombi of small arteries. CUA is commonly associated with secondary hyperparathyroidism and high serum calcium and phosphate products. This article reports an atypical case where CUA developed after parathyroidectomy and in the course of treatment of hungry bone syndrome. The patient was on hemodialysis for 14 years. He had developed secondary hyperparathyroidism and severe osteodystrophy. Calcium, Vitamin-D supplements, and calcimimetics failed to control his condition. He underwent parathyroidectomy but developed hungry bone syndrome postoperatively. He was managed with large doses of calcium and active Vitamin-D analogs to maintain his serum calcium. Two weeks later, he developed a painful single lesion on the tip of the penis which was diagnosed as CUA on clinical and radiographic evidence. The patient refused surgical intervention and opted for traditional treatment with honey and herbs with an excellent outcome. The case highlights the risk of CUA complicating the aggressive management of post-parathyroidectomy hungry bone syndrome.


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