Calciphylaxis in patients on hemodialysis: A prevalence study

Angelis, Michael; Wong, Linda L.; Myers, Sally; Wong, Livingston

doi:10.1016/s0039-6060(97)90212-9

Cited by 295 publications

(203 citation statements)

References 13 publications

Supporting

Mentioning

193

Contrasting

Unclassified

Order By: Relevance

“…Prevalence of CUA has been reported as 4% in hemodialysis patients (1), and the incidence of this disorder may be increasing in patients with ESKD (2). The reasons for the increasing incidence of CUA are unclear.…”

mentioning

confidence: 99%

Calciphylaxis from Nonuremic Causes

Nigwekar

Wolf²,

Sterns

et al. 2008

Clinical Journal of the American Society of Nephrology

362

384

View full text Add to dashboard Cite

Background and objectives: Calciphylaxis, or calcific uremic arteriolopathy, is a well-described entity in end-stage kidney disease and renal transplant patients; however, little systematic information is available on calciphylaxis from nonuremic causes. This systematic review was designed to characterize etiologies, clinical features, laboratory abnormalities, and prognosis of nonuremic calciphylaxis.Design, setting, participants, & measurements: A systematic review of literature for case reports and case series of nonuremic calciphylaxis was performed. Cases included met the operational definition of nonuremic calciphylaxis-histopathologic diagnosis of calciphylaxis in the absence of end-stage kidney disease, renal transplantation, or acute kidney injury requiring renal replacement therapy.Results: We found 36 cases (75% women, 63% Caucasian, aged 15 to 82 yr) of nonuremic calciphylaxis. Primary hyperparathyroidism, malignancy, alcoholic liver disease, and connective tissue disease were the most common reported causes. Preceding corticosteroid use was reported for 61% patients. Protein C and S deficiencies were seen in 11% of patients. Skin lesions were morphologically similar to calcific uremic arteriolopathy. Mortality rate was 52%, with sepsis being the leading cause of death.Conclusion: Calciphylaxis should be considered while evaluating skin lesions in patients with predisposing conditions even in the absence of end-stage kidney disease and renal transplantation. Nonuremic calciphylaxis is reported most often in white women. Mineral abnormalities that are invoked as potential causes in calcific uremic arteriolopathy are often absent, suggesting that heterogeneous mechanisms may contribute to its pathogenesis. Nonuremic calciphylaxis is associated with high mortality, and there is no known effective treatment.

show abstract

mentioning

confidence: 99%

Calciphylaxis from Nonuremic Causes

Nigwekar

Wolf²,

Sterns

et al. 2008

Clinical Journal of the American Society of Nephrology

362

384

View full text Add to dashboard Cite

show abstract

“…[1,9,11,12]. This precipitated product calcify the medium and small vessels and occlude them with resulting ischemia [1,2,9–11]. In our patient, her uncontrolled diabetes mellitus and history of vitamin D deficiency are possible precipitating factors for calciphylaxis.…”

Section: Discussionmentioning

confidence: 81%

“…End-stage renal disease, secondary hyperparathyroidism, hypercalcemia and hyperphosphatemia are proposed metabolic derangements which result in precipitation of calcium-phosphate in the presence of metallic salts such as iron and aluminium, egg albumin, trauma, etc. [1,9,11,12]. This precipitated product calcify the medium and small vessels and occlude them with resulting ischemia [1,2,9–11].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Multifactorial aetiology for non-uremic calciphylaxis: a case report

Basnet

Tachamo

Dhital

et al. 2018

Journal of Community Hospital Internal Medicine Perspectives

View full text Add to dashboard Cite

Calciphylaxis is commonly associated with end-stage renal disease patients on haemodialysis. We present a rare case of calciphylaxis in a non-uremic patient. The diagnosis was made clinically and confirmed with skin biopsy showing calcification of the dermal and subcutaneous tissues in the von Kossa stain. We believe that the combination of uncontrolled diabetes mellitus, a non-functioning paraganglioma and vitamin D deficiency in a susceptible female patient was responsible for causing calciphylaxis in our patient. An index of suspicion should be maintained by clinicians for calciphylaxis even in patients without uremia.

show abstract

“…It is commonly seen in end-stage renal disease (ESRD) patients with a prevalence of 1-4% of those on hemodialysis. 1,2 Incidence has been reported to be increasing recently. 3 With a high mortality between 60 and 80%, most patients die from complications of sepsis secondary to infection of the calciphylaxis wounds, which results from impaired integrity of the epidermis and dermis.…”

Section: Introductionmentioning

confidence: 99%

Patient Outcomes and Factors Associated with Healing in Calciphylaxis Patients Undergoing Adjunctive Hyperbaric Oxygen Therapy

McCulloch

Wojcik

Heyboer

2015

Journal of the American College of Clinical Wound Specialists

View full text Add to dashboard Cite

Calcific uremic arteriolopathy, also known as calciphylaxis, is a rare syndrome of small vessel calcification of unknown etiology causing painful, violaceous skin lesions that progress to form chronic non-healing ulcers and gangrene. Hyperbaric oxygen therapy (HBOT) can be used as adjunctive therapy in the treatment of these ulcers. However, due to paucity of cases, there is limited data on the clinical benefit of HBOT and identifying factors associated with healing. The purpose of this study was to determine patient outcomes and factors associated with healing in patients with calciphylaxis undergoing HBOT. A retrospective chart review was completed on patients who were diagnosed with calciphylaxis and had hyperbaric medicine consultation between May 2012 and January 2016. Clinical outcomes, demographics, risk factors, laboratory values, wound distribution, and HBOT profiles were collected and analyzed. We identified 8 patients. Out of 8 patients consulted for calciphylaxis, five were consented and underwent HBOT (2 males and 3 females). All had coexisting ESRD and Diabetes. All males were able to tolerate being in the chamber and received therapeutic treatments (at least 20 HBOT) with complete resolution of ulcers. HBOT was discontinued in one female due to an inconsistent biopsy report and two others due to death secondary to septic shock or respiratory arrest and severe uremia. Calciphylaxis is a devastating disease with a high mortality rate. Our results demonstrated a positive response to HBOT especially when receiving at least 20 treatments. A majority of calciphylaxis cases are females and indeed female gender has been cited as a risk factor for this disease. However, current literature has not conferred a relationship between gender nor the number of HBOT received and outcomes. Our results showed that males had a more favorable outcome provided they received at least twenty HBOT. Further prospective studies are needed to elucidate these outcomes.

show abstract

Calciphylaxis in patients on hemodialysis: A prevalence study

Cited by 295 publications

References 13 publications

Calciphylaxis from Nonuremic Causes

Calciphylaxis from Nonuremic Causes

Multifactorial aetiology for non-uremic calciphylaxis: a case report

Patient Outcomes and Factors Associated with Healing in Calciphylaxis Patients Undergoing Adjunctive Hyperbaric Oxygen Therapy

Contact Info

Product

Resources

About