title: Calciphylaxis: risk factors, diagnosis, and treatment.
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.
authors.affiliation: Division of Nephrology, Massachusetts General Hospital, Boston, MA. Electronic address: snigwekar@mgh.harvard.edu.
authors.forename: Sagar U
authors.initials: SU
authors.lastname: Nigwekar
authors.affiliation: Department of Dermatology, Massachusetts General Hospital, Boston, MA.
authors.forename: Daniela
authors.initials: D
authors.lastname: Kroshinsky
authors.affiliation: Pathology Service, Dermatopathology Unit, Massachusetts General Hospital, Boston, MA.
authors.forename: Rosalynn M
authors.initials: RM
authors.lastname: Nazarian
authors.affiliation: Burn Service, Department of Surgery, Massachusetts General Hospital, Boston, MA.
authors.forename: Jeremy
authors.initials: J
authors.lastname: Goverman
authors.affiliation: Division of Cardiology, Massachusetts General Hospital, Boston, MA.
authors.forename: Rajeev
authors.initials: R
authors.lastname: Malhotra
authors.affiliation: Palliative Care Division, Massachusetts General Hospital, Boston, MA.
authors.forename: Vicki Ann
authors.initials: VA
authors.lastname: Jackson
authors.affiliation: Palliative Care Division, Massachusetts General Hospital, Boston, MA.
authors.forename: Mihir M
authors.initials: MM
authors.lastname: Kamdar
authors.affiliation: Division of Nephrology, Massachusetts General Hospital, Boston, MA.
authors.forename: David J R
authors.initials: DJ
authors.lastname: Steele
authors.affiliation: Division of Nephrology, Massachusetts General Hospital, Boston, MA.
authors.forename: Ravi I
authors.initials: RI
authors.lastname: Thadhani
mesh_terms: D000818:Animals; D001160:Arterioles / Q000473:pathology; D001706:Biopsy; D002115:Calciphylaxis / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology / Q000628:therapy; D016022:Case-Control Studies; D012080:Chronic Kidney Disease-Mineral and Bone Disorder / Q000150:complications; D003131:Combined Modality Therapy; D015897:Comorbidity; D003928:Diabetic Nephropathies / Q000150:complications; D004195:Disease Models, Animal; D004573:Electrolytes / Q000097:blood; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000150:complications; D007676:Kidney Failure, Chronic / Q000150:complications; D044342:Malnutrition / Q000150:complications / Q000178:diet therapy; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D059408:Pain Management; D051381:Rats; D012307:Risk Factors; D012772:Shock, Septic / Q000209:etiology; D012867:Skin / Q000098:blood supply / Q000473:pathology; D013885:Thiosulfates / Q000627:therapeutic use; D014511:Uremia / Q000150:complications; D014808:Vitamin D Deficiency / Q000150:complications; D014945:Wound Healing
chemical_list: D004573:Electrolytes; D013885:Thiosulfates; C017717:sodium thiosulfate
keywords: Calcific uremic arteriolopathy; calciphylaxis; review; risk factors; sodium thiosulfate; warfarin