Buprenorphine for Intractable Pain of Skin Ulcer Associated with Calcific Uremic Arteriolopathy (Calciphylaxis): A Case Report

ABSTRACT

Purpose: To describe a patient receiving maintenance hemodialysis complicated with calcific uremic arteriolopathy (calciphylaxis) in whom ulcer pain control was successfully achieved by buprenorphine. Case A 75-year-old man was admitted due to intractable, extreme pain, which was accompanied by skin ulcers of the lower extremities. By a series of examinations including skin biopsy, the lesion was diagnosed to be calcific uremic arteriolopathy. The pain was not controllable with non-steroidal anti-inflammatory drugs and even by the nerve block. Buprenorphine, a partial agonist for the opioid receptor, markedly alleviated the mixed pain which was attenuated from Numerical Rating Scale (NRS) 10/10 to 0-2/10. Conclusion: Buprenorphine was very effective for the refractory pain control in a patient with skin ulcer due to calcific uremic arteriolopathy.