Calciphylaxis: risk factors, diagnosis, and treatment

Am J Kidney Dis. 2015 Jul;66(1):133-46. doi: 10.1053/j.ajkd.2015.01.034. Epub 2015 May 7.

Abstract

Calciphylaxis is a rare but devastating condition that has continued to challenge the medical community since its early descriptions in the scientific literature many decades ago. It is predominantly seen in patients with chronic kidney failure treated with dialysis (uremic calciphylaxis) but is also described in patients with earlier stages of chronic kidney disease and with normal kidney function. In this review, we discuss the available medical literature regarding risk factors, diagnosis, and treatment of both uremic and nonuremic calciphylaxis. High-quality evidence for the evaluation and management of calciphylaxis is lacking at this time due to its rare incidence and poorly understood pathogenesis and the relative paucity of collaborative research efforts. We hereby provide a summary of recommendations developed by a multidisciplinary team for patients with calciphylaxis.

Keywords: Calcific uremic arteriolopathy; calciphylaxis; review; risk factors; sodium thiosulfate; warfarin.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Arterioles / pathology
  • Biopsy
  • Calciphylaxis / diagnosis
  • Calciphylaxis / epidemiology
  • Calciphylaxis / etiology*
  • Calciphylaxis / pathology
  • Calciphylaxis / therapy
  • Case-Control Studies
  • Chronic Kidney Disease-Mineral and Bone Disorder / complications
  • Combined Modality Therapy
  • Comorbidity
  • Diabetic Nephropathies / complications
  • Disease Models, Animal
  • Electrolytes / blood
  • Fatal Outcome
  • Female
  • Humans
  • Hyperparathyroidism, Secondary / complications
  • Kidney Failure, Chronic / complications
  • Malnutrition / complications
  • Malnutrition / diet therapy
  • Middle Aged
  • Obesity / complications
  • Pain Management
  • Rats
  • Risk Factors
  • Shock, Septic / etiology
  • Skin / blood supply
  • Skin / pathology
  • Thiosulfates / therapeutic use
  • Uremia / complications
  • Vitamin D Deficiency / complications
  • Wound Healing

Substances

  • Electrolytes
  • Thiosulfates
  • sodium thiosulfate