Calciphylaxis After Kidney Transplant

Ryan, Michael P.; Ross, Lindy

doi:10.7759/cureus.4695

Cited by 5 publications

(2 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Therefore, understanding high-risk factors for calciphylaxis can provide important clues for further exploration of the exact etiology, while it is critical to the development of prevention and treatment measures in future. Risk factors proposed in previous studies include ESKD, female, obesity, diabetes, autoimmune disorders, primary or secondary hyperparathyroidism, hypercalcemia, hyperphosphatemia, hypoproteinemia, elevated alkaline phosphatase (ALP), vitamin K deficiency, hypercoagulable state, warfarin therapy, application history of high doses of calcium or activated vitamin D and long-term use of glucocorticoids or immunosuppressant, subcutaneous injection of insulin or heparin, kidney transplant, iron overload and so on [ 3 , 6 , 9 , 10 ]. Due to the differences in race, region, medication habits and dialysis prescriptions, the results of risk factors studies in different countries are varied and controversial.…”

Section: Introductionmentioning

confidence: 99%

Risk factors for calciphylaxis in Chinese hemodialysis patients: a matched case-control study

et al. 2021

View full text Add to dashboard Cite

Introduction: Calciphylaxis is a rare but potentially fatal disease commonly occurred in dialysis patients. Despite some previous studies on risk factors for calciphylaxis, there is still a lack of data from Chinese population. Methods: The retrospective matched case-control study about calciphylaxis was performed in Zhongda Hospital affiliated to Southeast University. The case group involved 20 hemodialysis patients who were newly diagnosed with calciphylaxis from October 2017 to December 2018. The 40 noncalciphylaxis patients undergoing dialysis with the same age and duration of dialysis were randomly selected as controls. Results: Most of calciphylaxis patients were male and elderly, while overweight people were more susceptible to the disease. Although incidence of secondary hyperparathyroidism was higher in calciphylaxis patients, the differences in duration of elevated serum intact parathyroid hormone (iPTH) and its highest value did not reach statistical significance compared with controls. No significant difference in warfarin therapy was discernible between two groups. The univariate regression analysis indicated that male, score of use of activated vitamin D and its analogues, corrected serum calcium level, serum phosphate, Ca Â P product, iPTH, albumin, and alkaline phosphatase (ALP) level were significantly associated with calciphylaxis. Elevated levels of serum phosphate (OR 4.584, p ¼ 0.027) and ALP (OR 1.179, p ¼ 0.036), decreased level of serum albumin (OR 1.330, p ¼ 0.013) were independent risk factors after multivariate analysis. Conclusion: This is the first report of risk factors associated with calciphylaxis in China. Increased levels of serum phosphate and ALP, decreased level of serum albumin were vital high-risk factors for calciphylaxis in Chinese hemodialysis population.

show abstract

Section: Introductionmentioning

confidence: 99%

Risk factors for calciphylaxis in Chinese hemodialysis patients: a matched case-control study

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Treatment of the underlying condition is key as the prognosis is poor, even with specific medications. Treatment guidelines include an increase in the frequency of dialysis in patients with ESRD, adequate wound care, topical antibacterial, use of thrombolytic agents, hyperbaric oxygen, and sodium thiosulfate are frequently employed [13,[22][23][24][25]. Non-orthodox treatment options, like maggot larval debridement for extensive ulcerations and plasma exchange, have also been employed [14,23,25].…”

Section: Discussionmentioning

confidence: 99%

Calciphylaxis: A Rare Clinical Presentation in a Patient with End-Stage Renal Disease (ESRD)

Okikiade

Browne-Caesar²,

Afolayan-Oloye

et al. 2023

AIR

View full text Add to dashboard Cite

Calciphylaxis, also known as calcific uremic arteriolopathy (CUA), affects small arteries of the skin in patients with end-stage renal failure, dialysis patients, and patients with hypercalcemia. The condition is characterized by the calcification of small blood vessels leading to skin necrosis without inflammation. It is frequently complicated by superimposed infection and bleeding and has a high mortality rate. The rare condition is yet to be documented on the islands of Saint Vincent and the Grenadines. The authors have, therefore, made efforts to document, educate, and discuss this rare presentation in a 65-year-old local Vincentian male with 30 years history of poorly controlled diabetes mellitus and hypertension who commenced hemodialysis two years prior to the presentation for end-stage chronic renal failure. With the increasing incidence and prevalence of diabetes mellitus, hypertension, and complications of chronic kidney disease, and renal failure, this article is written as a case study with a concise literature review on calciphylaxis to provide continuing medical education and increase the level of awareness among medical students and index of suspicion among healthcare providers.

show abstract

Development of calciphylaxis in kidney transplant recipients with a functioning graft

Guillén

Torregrosa

García‐Herrera

et al. 2021

Clinical Kidney Journal

View full text Add to dashboard Cite

Background calciphylaxis is not uniquely observed in uremic patients, as some cases have also been reported in patients with normal renal function or moderate chronic kidney disease (CKD), in association with severe vasculopathy or systemic inflammation. A particular subset worthy of studying is represented by those patients who develop calciphylaxis after kidney transplantation (KT). Methods analysis of the local series of calciphylaxis after KT (n = 14) along with all the other cases reported in the literature from 1969 to 2019 (n = 31), for a total population of 45 patients. Demographic data, CKD history, risk factors, immunosuppression, clinical presentation and management have been analyzed as a whole and according to the time-period (before or after 2000). Results calciphylaxis developed during the first year after KT in 43.2% of patients and median creatinine at diagnosis was 2.4[1.25–4.64]mg/dl. The most frequent presentation included distal purpura or ulcers in one third of cases, and 39.1% of patients were receiving vitamin K antagonists. PTH values were above 500pg/ml and below 100pg/ml in 50.0% and 25.0% of cases, respectively. Whole population mortality was 55.6%. As expected, clinical presentation, immunosuppression and management varied depending on the time period. Patients diagnosed after 2000s were older, with longer dialysis vintage and treatment was usually multimodal; on the contrary, in patients diagnosed before 2000s parathyroidectomy was the treatment of choice in 61.9% of cases. Conclusions calciphylaxis can still occur after KT, in many cases during the first year and in patients with a good renal function. Risk factors and management depended according to the time-period studied.

show abstract

Calciphylaxis After Kidney Transplant

Cited by 5 publications

References 7 publications

Risk factors for calciphylaxis in Chinese hemodialysis patients: a matched case-control study

Risk factors for calciphylaxis in Chinese hemodialysis patients: a matched case-control study

Calciphylaxis: A Rare Clinical Presentation in a Patient with End-Stage Renal Disease (ESRD)

Development of calciphylaxis in kidney transplant recipients with a functioning graft

Contact Info

Product

Resources

About