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Year : 2013  |  Volume : 4  |  Issue : 2  |  Page : 3

Penile necrosis in association with chronic renal failure; Calciphylaxis or Calcific uremic arteriolopathy

Shri Guru Ram Rai Institute of Medical and Health Sciences,Patel Nagar,Dehradun 248001 India

Correspondence Address:
A V Mathur
Department of Surgery, Shri Guru Ram Rai Institute of Medical and Health Sciences, Patel Nagar, Dehradun 248001 India

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Penile necrosis occasionally occurs in patients with chronic renal failure, due to vascular calcification in association with high serum levels of calcium and/or phosphorus. The condition has been called calciphylaxis or calcific uremic arteriolopathy. Only about 120 patients have been reported worldwide so far. It occurs in about 4% of patients on maintenance hemodialysis in diabetes mellitus with renal failure. The numbers of such patients are likely to increase. We present a known patient with diabetes with renal failure who presented with necrosis of the distal shaft of penis and tips of toes. The patient needed partial amputation of the penis followed by amputation of the distal toes. The condition is significant because of the poor overall prognosis. For diagnosis, the small vessel thrombosis with calcification and hypertrophy of the intimal layer is pathognomic. In the absence of definite guidelines treatment modalities include surgical debridement supported by antibiotics, biophosphonates, sodium thiosulphate, cinacalcet and tissue plasminogen activator.

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