Vascular calcification, thromboses and necroses occurring in patients with CKD. Unique features include medial (tunica media) arterial calcification with mural calcification of small vessels. Calcification of surrounding fat tissue and vascular fibrosis may be present. Tissue ischemia results from the vascular thromboses and soft tissue calcification. Presentation may include characteristic purplish, asymmetrical cutaneous lesions that become necrotic. Systemic, organ involvement is possible to include kidney, adrenal glands, stomach, lungs and heart - may be referred to as "stone heart." The prevalence may approach 4% while the incidence is approximately 1% per year. Predisposing factors include diabetes, malnutrition and hypoalbuminemia associated with chronic inflammation, atherosclerosis, hypercalcemia, hyperphosphatemia, hypertension, hypervitaminosis D, and milk-alkali syndrome. May be referred to as calcemic uremic arteriolopathy (CUA), uremic gangrene syndrome, metastatic calcification, and uremic small vessel disease.
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