title: Fetuin-A-containing calciprotein particle levels can be reduced by dialysis, sodium thiosulphate and plasma exchange. Potential therapeutic implications for calciphylaxis?
abstract: Calciprotein particles (CPP) are a novel marker of mineral stress. High levels of CPP are found in patients with calciphylaxis, a condition associated with marked vascular calcification and a poor prognosis. We report substantial reductions in CPP levels in a dialysis patient having combined haemodialysis (HD) and plasma exchange (PEx) prior to an ABO-incompatible kidney transplant. We also report the effects of the same treatments combined with sodium thiosulphate (STS) in a patient newly diagnosed with calciphylaxis. Combining HD with intra-dialytic STS and PEx we achieved a significant reduction in CCP with the least rebound between treatment sessions. After 6 weeks of treatment, the CPP reduction was paralleled by clinical improvement. Measurement of CPP may be an attractive marker for monitoring the effectiveness of calciphylaxis therapy.
authors.affiliation: Department of Renal Medicine, Eastern Health, Melbourne, Victoria, Australia.
authors.forename: Michael M X
authors.initials: MM
authors.lastname: Cai
authors.forename: Edward R
authors.initials: ER
authors.lastname: Smith
authors.forename: Catherine
authors.initials: C
authors.lastname: Brumby
authors.forename: Lawrence P
authors.initials: LP
authors.lastname: McMahon
authors.forename: Stephen G
authors.initials: SG
authors.lastname: Holt
mesh_terms: D000328:Adult; D002115:Calciphylaxis / Q000628:therapy*; D005260:Female; D006801:Humans; D008875:Middle Aged; D010951:Plasma Exchange; D006435:Renal Dialysis; D013885:Thiosulfates / Q000737:chemistry*; D060749:alpha-2-HS-Glycoprotein / Q000737:chemistry*
chemical_list: D013885:Thiosulfates; D060749:alpha-2-HS-Glycoprotein; C017717:sodium thiosulfate
keywords: calciphylaxis; plasma exchange; renal insufficiency; sodium thiosulphate; vascular calcification