Calciphylaxis is a severe and complex syndrome involving vascular calcification, thrombosis, and skin necrosis. Although the condition is relatively rare, occurring almost exclusively in patients with advanced (Stage 5) chronic kidney disease (CKD), it can often be fatal. In fact, mortality rates higher than 50 percent are reported within one year of diagnosis, mostly due to septicemia, with an 80 percent mortality rate overall.(1)
Although the term calciphylaxis has been widely used since the 1960s, an alternative and more rigorous term is ‘calcific uremic arteriolopathy (CUA)’, which describes the pathophysiology and predominant pathological findings associated with the condition.(1)
Although calciphylaxis typically occurs in patients with end stage renal disease (ESRD), it can also sometimes be observed in patients with normal renal function. In addition to CKD and ESRD, other known risk factors for calciphylaxis include diabetes mellitus, obesity, hyperphosphatemia, mineral disorders, and exposure to warfarin anticoagulation.(2) The condition is also more prevalent among females and among individuals of Caucasian ethnicity.(3) Overall, the estimated prevalence of calciphylaxis is reported to be up to 4% in patients on dialysis.(2)
Calciphylaxis is a complex disorder with a multifactorial etiology and an ambiguous pathogenesis.(1) Although different treatment strategies are available, their success is often limited. The focus of management, therefore, currently rests in disease prevention among patients with known risk factors. This can be achieved by controlling blood sugars in patients with diabetes mellitus and monitoring calcium-phosphate homeostasis, for example.(1)
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Calciphylaxis Diagnosis and Management
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Sources
1. Bhambri S, Bhambri A, Del Rosso JA. Calciphylaxis: A review. J Clin Aesthet Dermatol 2008; 1: 38-41
2. Sowers KM, Hayden MR. Calcific uremic arteriolopathy: pathophysiology, reactive oxygen species and therapeutic approaches. Oxid Med Cell Longev. 2010;3(2):109-21.
3. Brandenburg VM, Cozzolino M, Ketteler M. Calciphylaxis: a still unmet challenge. J Nephrol. 2011;24(2):142-8.
i recently had a patient die from this …..so also have seen this pitiful disease,very sad!
i recently had a patient die from this disease so have seen it also,…very pitiful.
I know a CNS WOCN who has successfully trested this condition. I’m hoping that she publishes her work.
Yes it certainly would! I would love to know what her treatment plan was. Let us know if you can.
Thank you for sharing. Good info to know.
Thanks Laurene. You might like these other interesting posts about Calciphylaxis
We have treated one patient successfully with once a day dressing changes and silvadene cream. She is the only one out of a small handfull that has survived this disease in our hospital. Her diagnosis was 1 1/2 years ago.
That’s fantastic! How is she doing now?
My mother is 73 years old and was diagnosed with Calciphylaxis about a month and a half ago. It is now October 18, 2019. She had been to the hospital 2 months prior for a procedure where 3 stents were put in for her heart condition. She has end stage renal failure and currently does peritoneal dialysis. She has been prescribed Dilaudid pain medication which has minimal reduction of pain. She is undergoing Sodium Thiosulfate treatment 3 times a week. This has made her nauseous and uncomfortable. This is a horrible disease and something i hope gets more recognition from both physicians and the general public. I don’t know how this will progress, but i am aware of the typical outcome. Unfortunately so is my mother. It’s a very troublesome thing to experience and watch.
John,
We know it is tough to watch loved ones suffer. You can always find a wound specialist in your area through the following link, which may be helpful in getting a second opinion – https://portal.abwmcertified.org/ABWMweb/Directory/ABWMcontent/Directory.aspx