Autologous platelet-rich plasma therapy for skin ulceration due to calcific uremic arteriopathy: a case report and review of the literature.

INTRODUCTION: Calcific uremic arteriolopathy (CUA) is a rare, but severe complication primarily affecting end-stage kidney disease (ESKD) patients on dialysis. It is characterized by calcification of small and medium-sized blood vessels, leading to ischemia and the development of painful, non-healing cutaneous ulcers. Although platelet-rich plasma (PRP), which is enriched with growth factors, has shown efficacy in treating various chronic ulcers, its use in CUA-related wounds remains poorly documented.

OBJECTIVE: This case report describes the novel application of PRP therapy in managing CUA-associated skin ulcers in an ESKD patient. The aim of this study was to evaluate the safety of this treatment and document preliminary clinical outcomes.

CASE REPORT: A patient with ESKD and CUA-related non-healing skin ulcers, who showed no improvement despite medical management for secondary hyperparathyroidism, hyperphosphatemia, and hypercalcemia, experienced progressive wound healing following autologous PRP therapy. The PRP was prepared using a two-step centrifugation process and applied topically after wound debridement. Over five PRP treatment sessions at 5-day intervals within 25 days, the patient achieved complete wound closure (100% reduction from 1.5 to 0 cm2), reduced exudate, and overall clinical recovery.

CONCLUSION: As an autologous product, PRP demonstrated complete wound resolution in this dialysis patient with CUA-associated refractory ulcers that were unresponsive to conventional therapies. These findings suggest that PRP may be considered as an adjunct therapy for calcific arteriolopathy, though further validation through controlled clinical trials is warranted.