title: We Do Too Many Parathyroidectomies for Calciphylaxis.
abstract: Calciphylaxis, a disorder of dermal arteriolar calcification with a distinct predilection for patients with advanced kidney disease, remains an enigmatic condition that challenges clinicians. Observations regarding positive associations between levels of circulating parathyroid hormone (PTH) and the risk of calciphylaxis, combined with experimental data suggesting a pathogenic role of secondary hyperparathyroidism in vascular calcification, have led to the assumption that reducing PTH levels will improve the outcomes in patients with calciphylaxis. This editorial communicates the contemporary data regarding surgical parathyroidectomy as a treatment option for these patients. We raise concerns regarding the quality of available data and discuss the direction of future comparative effectiveness research in this field.
authors.affiliation: Division of Nephrology, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Sagar U
authors.initials: SU
authors.lastname: Nigwekar
authors.affiliation: Division of Nephrology and Hypertension, NorthShore University HealthSystem, University of Chicago Pritzker School of Medicine, Evanston, Illinois.
authors.forename: Stuart M
authors.initials: SM
authors.lastname: Sprague
mesh_terms: D002115:Calciphylaxis / Q000601:surgery*; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000503:physiopathology; D007676:Kidney Failure, Chronic / Q000503:physiopathology; D009398:Nephrology / Q000379:methods*; D010281:Parathyroid Hormone / Q000097:blood; D016105:Parathyroidectomy; D061205:Vascular Calcification / Q000503:physiopathology
chemical_list: D010281:Parathyroid Hormone