Treatment of Calciphylaxis in CKD: A Systematic Review and Meta-analysis

Suwasin Udomkarnjananun, Kitravee Kongnatthasate, Kearkiat Praditpornsilpa, Somchai Eiam-Ong, Bertrand L Jaber, Paweena Susantitaphong, Suwasin Udomkarnjananun, Kitravee Kongnatthasate, Kearkiat Praditpornsilpa, Somchai Eiam-Ong, Bertrand L Jaber, Paweena Susantitaphong

Abstract

Background: Calciphylaxis is a life-threatening complication of chronic kidney disease (CKD). To inform clinical practice, we performed a systematic review of case reports, case series, and cohort studies to synthesize the available treatment modalities and outcomes of calciphylaxis in patients with CKD.

Methods: Electronic databases were searched for studies that examined the uses of sodium thiosulfate, surgical parathyroidectomy, calcimimetics, hyperbaric oxygen therapy, and bisphosphonates for calciphylaxis in patients with CKD, including end-stage renal disease. For cohort studies, the results were synthesized quantitatively by performing random-effects model meta-analyses.

Results: A total of 147 articles met the inclusion criteria and were included in the systematic review. There were 90 case reports (90 patients), 20 case series (423 patients), and 37 cohort studies (343 patients). In the pooled cohorts, case series, and case reports, 50.3% of patients received sodium thiosulfate, 28.7% underwent surgical parathyroidectomy, 25.3% received cinacalcet, 15.3% underwent hyperbaric oxygen therapy, and 5.9% received bisphosphonates. For the subset of cohort studies, by meta-analysis, the pooled risk ratio for mortality was not significantly different among patients who received sodium thiosulfate (pooled risk ratio [RR] 0.89; 95% confidence interval [CI] 0.71-1.12), cinacalcet (pooled RR 1.04; 95% CI 0.75-1.42), hyperbaric oxygen therapy (pooled RR 0.89; 95% CI 0.71-1.12), and bisphosphonates (pooled RR 0.77; 95% CI 0.44-1.32), and those who underwent surgical parathyroidectomy (pooled RR 0.88; 95% CI 0.69-1.13).

Conclusion: This systematic review found no significant clinical benefit of the 5 most frequently used treatment modalities for calciphylaxis in patients with CKD. Randomized controlled trials are needed to test the efficacy of these therapies.

Keywords: calciphylaxis; chronic kidney disease; meta-analysis; systematic review.

Figures

Figure 1
Figure 1
Flow diagram of study selection. CKD, chronic kidney disease.

References

    1. Moe S.M., Chen N.X. Calciphylaxis and vascular calcification: a continuum of extra-skeletal osteogenesis. Pediatr Nephrol. 2003;18:969–975.
    1. Mazhar A.R., Johnson R.J., Gillen D. Risk factors and mortality associated with calciphylaxis in end-stage renal disease. Kidney Int. 2001;60:324–332.
    1. Nigwekar S.U., Zhao S., Wenger J. A nationally representative study of calcific uremic arteriolopathy risk factors. J Am Soc Nephrol. 2016;27:3421–3429.
    1. Brandenburg V.M., Kramann R., Rothe H. Calcific uraemic arteriolopathy (calciphylaxis): data from a large nationwide registry. Nephrol Dial Transplant. 2017;32:126–132.
    1. Nigwekar S.U., Kroshinsky D., Nazarian R.M. Calciphylaxis: risk factors, diagnosis, and treatment. Am J Kidney Dis. 2015;66:133–146.
    1. Rogers N.M., Teubner D.J.O., Coates P.T.H. Calcific uremic arteriolopathy: advances in pathogenesis and treatment. Semin Dial. 2007;20(2):150–157.
    1. Wilmer W.A., Magro C.M. Calciphylaxis: Emerging concepts in prevention, diagnosis, and treatment. Semin Dial. 2002;15:172–186.
    1. An J., Devaney B., Ooi K.Y. Hyperbaric oxygen in the treatment of calciphylaxis: a case series and literature review. Nephrology. 2015;20:444–450.
    1. Hayden M.R., Goldsmith D.J.A. Sodium thiosulfate: new hope for the treatment of calciphylaxis. Semin Dial. 2010;23:258–262.
    1. Torregrosa J.V., Sánchez-Escuredo A., Barros X. Clinical management of calcific uremic arteriolopathy before and after therapeutic inclusion of bisphosphonates. Clin Nephrol. 2015;83(4):231–234.
    1. Torregrosa J.V., Duran C.E., Barros X. Successful treatment of calcific uraemic arteriolopathy with bisphosphonates. Nefrologia. 2012;32:329–334.
    1. Patecki M., Lehmann G., Brasen J.H. A case report of severe calciphylaxis—suggested approach for diagnosis and treatment. BMC Nephrol. 2017;18:137.
    1. Sewell L.D., Weenig R.H., Davis M.D. Low-dose tissue plasminogen activator for calciphylaxis. Arch Dermatol. 2004;140:1045–1048.
    1. El-Azhary R.A., Arthur A.K., Davis M.D.P. Retrospective analysis of tissue plasminogen activator as an adjuvant treatment for calciphylaxis. JAMA Dermatol. 2013;149:63–67.
    1. Liberati A., Altman D.G., Tetzlaff J. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. PLoS Med. 2009;6:e1000100.
    1. Dekkers O.M., Egger M., Altman D.G., Vandenbroucke J.P. Distinguishing case series from cohort studies. Ann Intern Med. 2012;156:37–40.
    1. Mathes T., Pieper D. Clarifying the distinction between case series and cohort studies in systematic reviews of comparative studies: potential impact on body of evidence and workload. BMC Med Res Methodol. 2017;17:107.
    1. Gagnier J.J., Kienle G., Altman D.G. The CARE guidelines: consensus-based clinical case report guideline development. J Clin Epidemiol. 2014;67:46–51.
    1. von Elm E., Altman D.G., Egger M. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Epidemiology. 2007;18:800–804.
    1. Chan Y.L., Mahony J.F., Turner J.J., Posen S. The vascular lesions associated with skin necrosis in renal disease. Br J Dermatol. 1983;109:85–95.
    1. Cockerell C.J., Dolan E.T. Widespread cutaneous and systemic calcification (calciphylaxis) in patients with the acquired immunodeficiency syndrome and renal disease. J Am Acad Dermatol. 1992;26:559–562.
    1. Fine A., Fleming S., Leslie W. Calciphylaxis presenting with calf pain and plaques in four continuous ambulatory peritoneal dialysis patients and in one predialysis patient. Am J Kidney Dis. 1995;25:498–502.
    1. Hafner J., Keusch G., Wahl C. Uremic small-artery disease with medial calcification and intimal hyperplasia (so-called calciphylaxis): A complication of chronic renal failure and benefit from parathyroidectomy. J Am Acad Dermatol. 1995;33:954–962.
    1. Lue C., Boulware D.W., Sanders P.W. Calciphylaxis mimicking skin lesions of connective tissue diseases. South Med J. 1996;89:1099–1100.
    1. Whittam L.R., McGibbon D.H., Macdonald D.M. Proximal cutaneous necrosis in association with chronic renal failure. Br J Dermatol. 1996;135:778–781.
    1. Bleyer A.J., Choi M., Igwemezie B. A case control study of proximal calciphylaxis. Am J Kidney Dis. 1998;32:376–383.
    1. Flanigan K.M., Bromberg M.B., Gregory M. Calciphylaxis mimicking dermatomyositis: ischemic myopathy complicating renal failure. Neurology. 1998;51:1634–1640.
    1. Jhaveri F.M., Woosley J.T., Fried F.A. Penile calciphylaxis: rare necrotic lesions in chronic renal failure patients. J Urol. 1998;160:764–767.
    1. Kasirajan K., Obermeyer R.J., Lucarelli M.R. Calciphylaxis: calcific angiopathy resulting in acral gangrene: case reports. Vascular and Endovascular Surgery. 1998;32:447–453.
    1. Oh D.H., Eulau D., Tokugawa D.A. Five cases of calciphylaxis and a review of the literature. J Am Acad Dermatol. 1999;40:979–987.
    1. Alain J., Poulin Y.P., Cloutier R.A. Calciphylaxis: seven new cases. J Cutan Med Surg. 2000;4:213–218.
    1. Girotto J.A., Harmon J.W., Ratner L.E. Parathyroidectomy promotes wound healing and prolongs survival in patients with calciphylaxis from secondary hyperparathyroidism. Surgery. 2001;130:645–651.
    1. Arch-Ferrer J.E., Beenken S.W., Rue L.W. Therapy for calciphylaxis: an outcome analysis. Surgery. 2003;134:941–944. discussion 944–945.
    1. Don B.R., Chin A.I. A strategy for the treatment of calcific uremic arteriolopathy (calciphylaxis) employing a combination of therapies. Clin Nephrol. 2003;59:463–470.
    1. Naik B.J., Lynch D.J., Slavcheva E.G., Beissner R.S. Calciphylaxis: medical and surgical management of chronic extensive wounds in a renal dialysis population. Plast Reconstr Surg. 2004;113:304–312.
    1. Polizzotto M.N., Bryan T., Ashby M.A., Martin P. Symptomatic management of calciphylaxis: a case series and review of the literature. J Pain Symptom Manage. 2006;32:186–190.
    1. Slough S., Servilla K.S., Harford A.M. Association between calciphylaxis and inflammation in two patients on chronic dialysis. Adv Perit Dial. 2006;22:171–174.
    1. Rickels M.R., Junkins-Hopkins J.M., Metkus T.S., Iqbal N. Calcific uremic arteriolopathy (calciphylaxis): case series and review of clinical features and terminology. Endocrinologist. 2007;17:57–62.
    1. Arenas M.D., Gil M.T., Gutiérrez M.D. Management of calcific uremic arteriolopathy (calciphylaxis) with a combination of treatments, including hyperbaric oxygen therapy. Clin Nephrol. 2008;70:261–264.
    1. Kacso I., Rusu A., Racasan S. Calcific uremic arteriolopathy related to hyperparathyroidism secondary to chronic renal failure. A case-control study. Acta Endocrinologica. 2008;4:391–400.
    1. Sulkova S.D., Valek M. Skin wounds associated with calciphylaxis in end-stage renal disease patients on dialysis. Nutrition. 2010;26:910–914.
    1. Baldwin C., Farah M., Leung M. Multi-intervention management of calciphylaxis: a report of 7 cases. Am J Kidney Dis. 2011;58:988–991.
    1. Noureddine L., Landis M., Patel N., Moe S.M. Efficacy of sodium thiosulfate for the treatment for calciphylaxis. Clin Nephrol. 2011;75:485–490.
    1. Sood A.R., Wazny L.D., Raymond C.B. Sodium thiosulfate-based treatment in calcific uremic arteriolopathy: a consecutive case series. Clin Nephrol. 2011;75:8–15.
    1. Malabu U.H., Manickam V., Kan G. Calcific uremic arteriolopathy on multimodal combination therapy: Still unmet goal. Int J Nephrol. 2012;2012
    1. Cohen G.F., Vyas N.S. Sodium thiosulfate in the treatment of calciphylaxis. J Clin Aesthet Dermatol. 2013;6:41–44.
    1. Salmhofer H., Franzen M., Hitzl W. Multi-modal treatment of calciphylaxis with sodium-thiosulfate, cinacalcet and sevelamer including long-term data. Kidney Blood Press Res. 2013;37:346–359.
    1. Veitch D., Wijesuriya N., McGregor J.M. Clinicopathological features and treatment of uremic calciphylaxis: a case series. Eur J Dermatol. 2014;24:113–115.
    1. Lee K.G., Lim A.E.L., Wong J., Choong L.H.L. Clinical features, therapy, and outcome of calciphylaxis in patients with end-stage renal disease on renal replacement therapy: case series. Hemodial Int. 2015;19:611–613.
    1. McCulloch N., Wojcik S.M., Heyboer M. Patient outcomes and factors associated with healing in calciphylaxis patients undergoing adjunctive hyperbaric oxygen therapy. J Am Coll Clin Wound Spec. 2015;7:8–12.
    1. Bourgeois P., De Haes P. Sodium thiosulfate as a treatment for calciphylaxis: a case series. J Dermatolog Treat. 2016;27:520–524.
    1. Grant A., Lee S. A case series and clinical update on calciphylaxis. Hong Kong Journal of Dermatology and Venereology. 2016;24:184–190.
    1. McCarthy J.T., el-Azhary R.A., Patzelt M.T. Survival, risk factors, and effect of treatment in 101 patients with calciphylaxis. Mayo Clin Proc. 2016;91:1384–1394.
    1. Zhang Y., Corapi K.M., Luongo M. Calciphylaxis in peritoneal dialysis patients: a single center cohort study. Int J Nephrol Renovasc Dis. 2016;9:235–241.
    1. Hlusicka J., Veisova E., Ullrych M. Serum calcium and phosphorus concentrations and the outcome of calciphylaxis treatment with sodium thiosulfate. Monatsh Chem. 2017;148:435–440.
    1. Gipstein R.M., Coburn J.W., Adams D.A. Calciphylaxis in man: a syndrome of tissue necrosis and vascular calcification in 11 patients with chronic renal failure. Arch Intern Med. 1976;136:1273–1280.
    1. Rubinger D., Friedlaender M.M., Silver J. Progressive vascular calcification with necrosis of extremities in hemodialysis patients: a possible role of iron overload. Am J Kidney Dis. 1986;7:125–129.
    1. Ivker R.A., Woosley J., Briggaman R.A. Calciphylaxis in three patients with end-stage renal disease. Arch Dermatol. 1995;131:63–68.
    1. Kriskovich M.D., Holman J.M., Haller J.R. Calciphylaxis: is there a role for parathyroidectomy? Laryngoscope. 2000;110:603–607.
    1. Mureebe L., Moy M., Balfour E. Calciphylaxis: a poor prognostic indicator for limb salvage. J Vasc Surg. 2001;33:1275–1279.
    1. Podymow T., Wherrett C., Burns K.D. Hyperbaric oxygen in the treatment of calciphylaxis: a case series. Nephrol Dial Transplant. 2001;16:2176–2180.
    1. Basile C., Montanaro A., Masi M. Hyperbaric oxygen therapy for calcific uremic arteriolopathy: a case series. J Nephrol. 2002;15:676–680.
    1. Milas M., Bush R.L., Lin P. Calciphylaxis and nonhealing wounds: the role of the vascular surgeon in a multidisciplinary treatment. J Vasc Surg. 2003;37:501–507.
    1. Bardsley S., Coutts R., Wilson C. Calciphylaxis and its surgical significance. ANZ J Surg. 2005;75:356–359.
    1. Matstusoka S., Tominaga Y., Uno N. Calciphylaxis: a rare complication of patients who required parathyroidectomy for advanced renal hyperparathyroidism. World J Surg. 2005;29:632–635.
    1. Araya C.E., Fennell R.S., Neiberger R.E., Dharnidharka V.R. Sodium thiosulfate treatment for calcific uremic arteriolopathy in children and young adults. Clin J Am Soc Nephrol. 2006;1:1161–1166.
    1. Maeda H., Tokumoto M., Yotsueda H. Two cases of calciphylaxis treated by parathyroidectomy: importance of increased bone formation. Clin Nephrol. 2007;67:397–402.
    1. O'Neil B., Southwick A.W. Three cases of penile calciphylaxis: diagnosis, treatment strategies, and the role of sodium thiosulfate. Urology. 2012;80:5–8.
    1. Garcia C.P., Roson E., Peon G. Calciphylaxis treated with sodium thiosulfate: report of two cases. Dermatol Online J. 2013;19:19616.
    1. Nigwekar S.U., Brunelli S.M., Meade D. Sodium thiosulfate therapy for calcific uremic arteriolopathy. Clin J Am Soc Nephrol. 2013;8:1162–1170.
    1. Zitt E., Konig M., Vychytil A. Use of sodium thiosulphate in a multi-interventional setting for the treatment of calciphylaxis in dialysis patients. Nephrol Dial Transplant. 2013;28:1232–1240.
    1. Malbos S., Urena-Torres P., Bardin T., Ea H.K. Sodium thiosulfate is effective in calcific uremic arteriolopathy complicating chronic hemodialysis. Joint Bone Spine. 2016;83:89–92.
    1. Russo D., Capuano A., Cozzolino M. Multimodal treatment of calcific uraemic arteriolopathy (calciphylaxis): a case series. Clin Kidney J. 2016;9:108–112.
    1. Santos P.W., He J., Tuffaha A., Wetmore J.B. Clinical characteristics and risk factors associated with mortality in calcific uremic arteriolopathy. Int Urol Nephrol. 2017;49:2247–2256.
    1. Fox R., Banowsky L.H., Cruz A.B., Jr. Post-renal transplant calciphylaxis: Successful treatment with parathyroidectomy. Journal of Urol. 1983;129:362–363.
    1. Vassa N., Twardowski Z.J., Campbell J. Hyperbaric oxygen therapy in calciphylaxis-induced skin necrosis in a peritoneal dialysis patient. Am J Kidney Dis. 1994;23:878–881.
    1. Rudwaleit M., Schwarz A., Trautmann C. Severe calciphylaxis in a renal patient on long-term oral anticoagulant therapy. Am J Nephrol. 1996;16:344–348.
    1. Boerma E.C., Hene R.J. A calcareous calamity. Nephrol Dial Transplant. 1997;12:2453–2454.
    1. Dean S.M., Werman H. Calciphylaxis: a favorable outcome with hyperbaric oxygen. Vasc Med. 1998;3:115–120.
    1. Katsamakis G., Lukovits T.G., Gorelick P.B. Calcific cerebral embolism in systemic calciphylaxis. Neurology. 1998;51:295–297.
    1. James L.R., Lajoie G., Prajapati D. Calciphylaxis precipitated by ultraviolet light in a patient with end- stage renal disease secondary to systemic lupus erythematosus. Am J Kidney Dis. 1999;34:932–936.
    1. Edwards R.B., Jaffe W., Arrowsmith J., Henderson H.P. Calciphylaxis: a rare limb and life threatening cause of ischaemic skin necrosis and ulceration. Br J Plast Surg. 2000;53:253–255.
    1. Patetsios P., Bernstein M., Kim S. Severe necrotizing mastopathy caused by calciphylaxis alleviated by total parathyroidectomy. Am Surg. 2000;66:1056–1058.
    1. Kay P.A., Sanchez W., Rose J.F. Calciphylaxis causing necrotizing mastitis: a case report. Breast. 2001;10:540–543.
    1. Dwyer K.M., Francis D.M.A., Hill P.A., Murphy B.F. Calcific uraemic arteriolopathy: local treatment and hyperbaric oxygen therapy [5] Nephrol Dial Transplant. 2002;17:1148–1149.
    1. Garrigue V., Lorho R., Canet S. Necrotic skin lesions in a dialysis patient: a multifactorial entity. Clin Nephrol. 2002;57:163–166.
    1. Nahm W.K., Badiavas E., Touma D.J. Calciphylaxis with peau d'orange induration and absence of classical features of purpura, livedo reticularis and ulcers. J Dermatol. 2002;29:209–213.
    1. Bahar G., Mimouni D., Feinmesser M. Subtotal parathyroidectomy: a possible treatment for calciphylaxis. Ear Nose Throat J. 2003;82:390–393.
    1. Parker R.W., Mouton C.P., Young D.W., Espino D.V. Early recognition and treatment of Calciphylaxis. South Med J. 2003;96:53–55.
    1. Cicone J.S., Petronis J.B., Embert C.D., Spector D.A. Successful treatment of calciphylaxis with intravenous sodium thiosulfate. Am J Kidney Dis. 2004;43:1104–1108.
    1. Monney P., Nguyen Q.V., Perroud H., Descombes E. Rapid improvement of calciphylaxis after intravenous pamidronate therapy in a patient with chronic renal failure. Nephrol Dial Transplant. 2004;19:2130–2132.
    1. Oikawa S., Osajima A., Tamura M. Development of proximal calciphylaxis with penile involvement after parathyroidectomy in a patient on hemodialysis. Intern Med. 2004;43:63–68.
    1. Brucculeri M., Cheigh J., Bauer G., Serur D. Long-term intravenous sodium thiosulfate in the treatment of a patient with calciphylaxis. Semin Dial. 2005;18:431–434.
    1. Guerra G., Shah R.C., Ross E.A. Rapid resolution of calciphylaxis with intravenous sodium thiosulfate and continuous venovenous haemofiltration using low calcium replacement fluid: case report. Nephrol Dial Transplant. 2005;20:1260–1262.
    1. Maroulis J.C., Fourtounas C., Vlachojannis J.G. Calciphylaxis: a complication of end-stage renal disease improved by parathyroidectomy. Hormones (Athens) 2006;5:210–213.
    1. Meissner M., Bauer R., Beier C. Sodium thiosulphate as a promising therapeutic option to treat calciphylaxis. Dermatology. 2006;212:373–376.
    1. Musso C.G., Enz P.A., Guelman R. Non-ulcerating calcific uremic arteriolopathy skin lesion treated successfully with intravenous ibandronate. Perit Dial Int. 2006;26:717–718.
    1. Sharma A., Burkitt-Wright E., Rustom R. Cinacalcet as an adjunct in the successful treatment of calciphylaxis. Br J Dermatol. 2006;155:1295–1297.
    1. Shiraishi N., Kitamura K., Miyoshi T. Successful treatment of a patient with severe calcific uremic arteriolopathy (calciphylaxis) by etidronate disodium. Am J Kidney Dis. 2006;48:151–154.
    1. Thang O.H.D., Jaspars E.H., ter Wee P.M. Necrotizing mastitis caused by calciphylaxis. Nephrol Dial Transplant. 2006;21:2020–2021.
    1. Tokashiki K., Ishida A., Kouchi M. Successful management of critical limb ischemia with intravenous sodium thiosulfate in a chronic hemodialysis patient. Clin Nephrol. 2006;66:140–143.
    1. Velasco N., MacGregor M.S., Innes A., MacKay I.G. Successful treatment of calciphylaxis with cinacalcet—an alternative to parathyroidectomy? Nephrol Dial Transplant. 2006;21:1999–2004.
    1. Ackermann F., Levy A., Daugas E. Sodium thiosulfate as first-line treatment for calciphylaxis. Arch Dermatol. 2007;143:1336–1337. author reply 1338.
    1. Bazari H., Jaff M.R., Mannstadt M., Yan S. Case records of the Massachusetts General Hospital. Case 7–2007. A 59-year-old woman with diabetic renal disease and nonhealing skin ulcers. N Engl J Med. 2007;356:1049–1057.
    1. Hanafusa T., Yamaguchi Y., Tani M. Intractable wounds caused by calcific uremic arteriolopathy treated with bisphosphonates. J Am Acad Dermatol. 2007;57:1021–1025.
    1. Lai M.Y., Lin Y.P., Yang W.C. Fever with fulminant skin necrosis and digital gangrene in a uraemic woman. Nephrol Dial Transplant. 2007;22:1473–1474.
    1. Aabed G., Furayh O.A., Al-Lehbi A. Calciphylaxis-associated second renal graft failure and patient loss: a case report and review of the literature. Exp Clin Transplant. 2008;6:287–293.
    1. Da Costa J.B., Da Costa A.G., Gomes M.M. Pamidronate as a treatment option in calciphylaxis. J Eur Acad Dermatol Venereol. 2008;22:1128–1130.
    1. Hitti W.A., Papadimitriou J.C., Bartlett S., Wali R.K. Spontaneous cutaneous ulcers in a patient with a moderate degree of chronic kidney disease: a different spectrum of calciphylaxis. Scand J Urol Nephrol. 2008;42:181–183.
    1. Kyritsis I., Gombou A., Griveas I. Combination of sodium thiosulphate, cinacalcet, and paricalcitol in the treatment of calciphylaxis with hyperparathyroidism. Int J Artif Organs. 2008;31:742–744.
    1. Mohammed I.A., Sekar V., Bubtana A.J. Proximal calciphylaxis treated with calcimimetic 'Cinacalcet.'. Nephrol Dial Transplant. 2008;23:387–389.
    1. Subramaniam K., Wallace H., Sinniah R., Saker B. Complete resolution of recurrent calciphylaxis with long-term intravenous sodium thiosulfate. Australas J Dermatol. 2008;49:30–34.
    1. TAN Bhatty, Riaz K. Calciphylaxis mimicking penile gangrene: A case report. ScientificWorldJournal. 2009;9:1355–1359.
    1. Kalisiak M., Courtney M., Lin A., Brassard A. Calcific uremic arteriolopathy (calciphylaxis): Successful treatment with sodium thiosulfate in spite of elevated serum phosphate. J Cutan Med Surg. 2009;13:S29–S34.
    1. León L.R. Treating distal calciphylaxis with therapy associated with sevelamer and bisphosphonates. Nefrologia. 2009;29:92–93.
    1. Musso C.G., Enz P., Vidal F. Use of sodium thiosulfate in the treatment of calciphylaxis. Saudi J Kidney Dis Transpl. 2009;20:1065–1068.
    1. Nigliazzo A., Khoo S., Saxe A. Calciphylaxis. Am Surg. 2009;75:516–518.
    1. Sánchez M.P., Pérez M.C., Lorman R.S., Borroy C.S. Proximal calciphylaxis in a liver and kidney transplant patient. Nefrologia. 2009;29:489–490.
    1. Shaheen M., Hammoud D., Patel D. Non-healing skin ulcers secondary to calciphylaxis with Candida tropicalis fungemia in an end-stage renal disease patient. Hong Kong Journal of Nephrology. 2009;11:66–69.
    1. Yeh S.M., Hwang S.J., Chen H.C. Treatment of severe metastatic calcification in hemodialysis patients. Hemodial Int. 2009;13:163–167.
    1. Campanino P.P., Tota D., Bagnera S. Breast calciphylaxis following coronary artery bypass grafting completely resolved with total parathyroidectomy. Breast J. 2010;16:544–547.
    1. Dong X.E., Bishop J., Brown E. Surgical management of calciphylaxis associated with primary hyperparathyroidism: a case report and review of the literature. Int J Endocrinol. 2010;2010
    1. Khalpey Z., Nehs M.A., Elbardissi A.W. The importance of prevention of calciphylaxis in patients who are at risk and the potential fallibility of calcimimetics in the treatment of calciphylaxis for patients with secondary hyperparathyroidism. NDT Plus. 2010;3:68–70.
    1. Kirschberg O., Saers T., Krakamp B. Calciphylaxis—case report and review of the literature. Dialysis and Transplantation. 2010;39:401–403.
    1. Brucculeri M., Haydon A.H. Calciphylaxis presenting in early chronic kidney disease with mixed hyperparathyroidism. Int J NephrolRenovasc Dis. 2011;4:157–160.
    1. Cadavid J.C., DiVietro M.L., Torres E.A. Warfarin-induced pulmonary metastatic calcification and calciphylaxis in a patient with end-stage renal disease. Chest. 2011;139:1503–1506.
    1. Castro H., Cabeza-Rivera F., Green D. Combined therapy with sodium thiosulfate and parathyroidectomy in a patient with calciphylaxis. Dialysis and Transplantation. 2011;40:264–266.
    1. Conde Rivera O., Camba Caride M., Novoa Fernandez E. Multidisciplinary treatment. A therapeutic option to treat calciphylaxis. Nefrologia. 2011;31:614–616.
    1. Khalpey Z., Tullius S.G. Refractory calciphylaxis. Am J Surg. 2011;202:e27.
    1. Miceli S., Milio G., Placa S.L. Sodium thiosulfate not always resolves calciphylaxis: an ambiguous response. Ren Fail. 2011;33:84–87.
    1. Scola N., Gackler D., Stucker M., Kreuter A. Complete clearance of calciphylaxis following combined treatment with cinacalcet and sodium thiosulfate. J Dtsch Dermatol Ges. 2011;9:1030–1031.
    1. Shiell K.A., Andrews P.A. A painful skin rash in a patient with Stage V chronic kidney disease. NDT Plus. 2011;4:201–204.
    1. Li J.Y.Z., Yong T.Y., Choudhry M. Successful treatment of calcific uremic arteriolopathy with sodium thiosulfate in a renal transplant recipient. Ren Fail. 2012;34:645–648.
    1. Lo Monte A.I., Bellavia M., Damiano G. A complex case of fatal calciphylaxis in a female patient with hyperparathyroidism secondary to end stage renal disease of graft and coexistence of haemolytic uremic syndrome. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2012;156:262–265.
    1. Marshall B.J., Johnson R.E. Case report on calciphylaxis: an early diagnosis and treatment may improve outcome. J Am Coll Clin Wound Spec. 2012;4:67–70.
    1. Sandhu G., Gini M.B., Ranade A. Penile calciphylaxis: a life-threatening condition successfully treated with sodium thiosulfate. Am J Ther. 2012;19:e66–e68.
    1. van Noten C., van Doorn K.J., Vermander E. Maximal conservative therapy of calcific uremic arteriolopathy. Clin Nephrol. 2012;78:61–63.
    1. Van Rijssen L.B., Brenninkmeijer E.E.A., Nieveen Van Dijkum E.J.M. Secondary hyperparathyroidism: uncommon cause of a leg ulcer. Int J Surg Case Rep. 2012;3:30–33.
    1. Burnie R., Smail S., Javaid M.M. Calciphylaxis and sodium thiosulphate: a glimmer of hope in desperate situation. J Ren Care. 2013;39:71–76.
    1. Checheriţã I.A., Smarandache D., Rãdulescu D. Calcific uremic arteriolopathy in hemodialyzed patients. Chirurgia (Bucur) 2013;108:736–740.
    1. Kumar V., Patel N. Images in vascular medicine. Calcific uremic arteriolopathy of the penis. Vasc Med. 2013;18:239.
    1. Seferi S., Barbullushi M., Rroji M. An unusual site of calciphylaxis: a case report and review of the literature. BANTAO Journal. 2013;11:40–45.
    1. Smith S., Inaba A., Murphy J. A case report: Radiological findings in an unusual case of calciphylaxis 16 years after renal transplantation. Skeletal Radiol. 2013;42:1623–1626.
    1. Steele K.T., Sullivan B.J., Wanat K.A. Diffuse dermal angiomatosis associated with calciphylaxis in a patient with end-stage renal disease. J Cutan Pathol. 2013;40:829–832.
    1. Vanparys J., Sprangers B., Sagaert X., Kuypers D.R. Chronic wounds in a kidney transplant recipient with moderate renal impairment. Acta Clin Belg. 2013;68:128–131.
    1. Deng Y., Xie G., Li C. Calcific uremic arteriolopathy ameliorated by hyperbaric oxygen therapy in high-altitude area. Ren Fail. 2014;36:1139–1141.
    1. Gallimore G.G., Curtis B., Smith A., Benca M. Curious case of calciphylaxis leading to acute mitral regurgitation. BMJ Case Rep. 2014;2014
    1. Sprague S.M. Painful skin ulcers in a hemodialysis patient. Clin J Am Soc Nephrol. 2014;9:166–173.
    1. Stavros K., Motiwala R., Zhou L. Calciphylaxis in a dialysis patient diagnosed by muscle biopsy. J Clin Neuromuscul Dis. 2014;15:108–111.
    1. Tindni A., Gaurav K., Panda M. Non-healing painful ulcers in a patient with chronic kidney disease and role of sodium thiosulfate: a case report. Cases J. 2014;1:178.
    1. Yeh H.T., Huang I.J., Chen C.M., Hung Y.M. Regression of vascular calcification following an acute episode of calciphylaxis: a case report. J Med Case Rep. 2014;8:52.
    1. Buscher K., Gabriëls G., Barth P., Pavenstädt H. Breast pain in a patient on dialysis: a rare manifestation of calcific uraemic arteriolopathy. BMJ Case Rep. 2015;2015
    1. Disbrow M.B., Qaqish I., Kransdorf M., Chakkera H.A. Calcific uraemic arteriolopathy. BMJ Case Rep. 2015;2015
    1. Sarkis E. Penile and generalised calciphylaxis in peritoneal dialysis. BMJ Case Rep. 2015;2015
    1. Tamayo-Isla R.A., Cruz M.C. Calciphylaxis in end-stage renal disease prior to dialytic treatment: a case report and literature review. Int J Nephrol Renovasc Dis. 2015;8:13–18.
    1. Yu Z., Gu L., Pang H. Sodium thiosulfate: an emerging treatment for calciphylaxis in dialysis patients. Case Rep Nephrol Dial. 2015;5:77–82.
    1. Aihara S., Yamada S., Uchida Y. The successful treatment of calciphylaxis with sodium thiosulfate and hyperbaric oxygen in a non-dialyzed patient with chronic kidney disease. Intern Med. 2016;55:1899–1905.
    1. Celik M., Ayturk S., Celik H. A rare clinical presentation: a patient with chronic renal failure, secondary hyperparathyroidism and calciphylaxis. Acta Endocrinologica. 2016;12:219–223.
    1. Kingi L., Grech R., Lam M. Calciphylaxis—a case study in a patient with Maori heritage. J Tissue Viability. 2016;25:216–219.
    1. Kurultak I., Kiliç I., Sezer B. Endocarditis and calcific uremic arteriolopathy: is it a coincidence or an association? Case report. Turkish Nephrology, Dialysis and Transplantation Journal. 2016;25:113–117.
    1. Lovgren M.L., Matthews A.G., Torley D. Painful ulcers. Clin Exp Dermatol. 2016;41:109–111.
    1. Ozdemir A.A., Altay M., Celebi A., Mavis O. Literature review in the treatment of calciphylaxis: a case with uncontrolled and severe secondary hyperparathyroidism. Caspian J Intern Med. 2016;7:57–60.
    1. Karmegam S., Shetty A. Calciphylaxis after parathyroidectomy. Hemodial Int. 2017;21:S62–S66.
    1. Miura S., Takahashi K., Akasaka T. Calciphylaxis presenting with various symptoms: a case report. Case Rep Dermatol. 2017;9:25–29.
    1. Ketteler M., Block G.A., Evenepoel P. Executive summary of the 2017 KDIGO Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD) Guideline Update: what's changed and why it matters. Kidney Int. 2017;92:26–36.
    1. Selye H., Gentile G., Prioreschi P. Cutaneous molt induced by calciphylaxis in the rat. Science. 1961;134:1876–1877.
    1. Mochel M.C., Arakaki R.Y., Wang G. Cutaneous calciphylaxis: a retrospective histopathologic evaluation. Am J Dermatopathol. 2013;35:582–586.
    1. Conn J., Jr., Krumlovsky F.A., Del Greco F., Simon N.M. Calciphylaxis: etiology of progressive vascular calcification and gangrene? Ann Surg. 1973;177:206–210.
    1. Gupta N., Haq K.F., Mahajan S. Gastrointestinal bleeding secondary to calciphylaxis. Am J Case Rep. 2015;16:818–822.
    1. Rivera-Nieves J., Bamias G., Alfert J. Intestinal ischemia and peripheral gangrene in a patient with chronic renal failure. Gastroenterology. 2002;122:495–499.
    1. Azegami T., Wakino S., Hayashi M., Itoh H. Severe systemic calciphylaxis with culture-negative endocarditis. Clin Kidney J. 2013;6:342–343.
    1. Ladino M., Sadhu S., Ortega L.M. Calcification of the liver in a patient on renal replacement therapy diagnosed with systemic calciphylaxis. NDT Plus. 2009;2:504–505.
    1. Nigwekar S.U., Wolf M., Sterns R.H., Hix J.K. Calciphylaxis from nonuremic causes: a systematic review. Clin J Am Soc Nephrol. 2008;3:1139–1143.
    1. St. Peter W.L., Wazny L.D., Weinhandl E.D. Phosphate-binder use in US dialysis patients: prevalence, costs, evidence, and policies. Am J Kidney Dis. 2018;71:246–253.
    1. Kumar S.V., Nagesh, Kumar V. A prospective study on prevalence, dialysis, and drug utilization of chronic renal failure patients. Int J Pharmacol Res. 2013;3:45–52.
    1. Schlieper G., Schurgers L., Brandenburg V. Vascular calcification in chronic kidney disease: an update. Nephrol Dial Transplant. 2016;31:31–39.
    1. Schlieper G., Brandenburg V., Ketteler M., Floege J. Sodium thiosulfate in the treatment of calcific uremic arteriolopathy. Nat Rev Nephrol. 2009;5:539–543.
    1. Peng T., Zhuo L., Wang Y. Systematic review of sodium thiosulfate in treating calciphylaxis in chronic kidney disease patients. Nephrology (Carlton) 2018;23:669–675.
    1. Lal G., Nowell A.G., Liao J. Determinants of survival in patients with calciphylaxis: a multivariate analysis. Surgery. 2009;146:1028–1034.
    1. Weenig R.H., Sewell L.D., Davis M.D.P. Calciphylaxis: natural history, risk factor analysis, and outcome. J Am Acad Dermatol. 2007;56:569–579.
    1. Katikaneni M., Lwin L., Villanueva H., Yoo J. Calciphylaxis and subtotal parathyroidectomy: a double-edged sword. Hemodial Int. 2013;17:S33–S36.
    1. Wahab M.A., Al Kanhal F. Calciphylaxis after parathyroidectomy in chronic renal failure. Saudi J Kidney Dis Transpl. 2008;19:854–860.
    1. Nigwekar S.U., Sprague S.M. We do too many parathyroidectomies for calciphylaxis. Semin Dial. 2016;29:312–314.
    1. Quarles L.D. Cinacalcet HCl: a novel treatment for secondary hyperparathyroidism in stage 5 chronic kidney disease. Kidney Int Suppl. 2005;96:S24–S28.
    1. Floege J., Kubo Y., Floege A. The effect of cinacalcet on calcific uremic arteriolopathy events in patients receiving hemodialysis: The EVOLVE trial. Clin J Am Soc Nephrol. 2015;10:800–807.
    1. Lima M.A., Farage L., Cury M.C., Bahamad F.J. Update on middle ear barotrauma after hyperbaric oxygen therapy-insights on pathophysiology. Int Arch Otorhinolaryngol. 2014;18:204–209.
    1. Lima M.A., Farage L., Cury M.C., Bahmad F., Jr. Middle ear barotrauma after hyperbaric oxygen therapy—the role of insuflation maneuvers. Int Tinnitus J. 2012;17:180–185.
    1. Vahidova D., Sen P., Papesch M. Does the slow compression technique of hyperbaric oxygen therapy decrease the incidence of middle-ear barotrauma? J Laryngol Otol. 2006;120:446–449.
    1. Drake M.T., Clarke B.L., Khosla S. Bisphosphonates: mechanism of action and role in clinical practice. Mayo Clin Proc. 2008;83:1032–1045.
    1. Raymond C.B., Wazny L.D. Sodium thiosulfate, bisphosphonates, and cinacalcet for treatment of calciphylaxis. Am J Health Syst Pharm. 2008;65:1419–1429.
    1. Brandenburg V.M., Evenepoel P., Floege J. Lack of evidence does not justify neglect: how can we address unmet medical needs in calciphylaxis? Nephrol Dial Transplant. 2016;31:1211–1219.
    1. Brandenburg V., Adragao T., Dam B.V. Blueprint for a European calciphylaxis registry initiative: The European Calciphylaxis Network (EuCalNet) Clin Kidney J. 2015;8:567–571.
    1. Nigwekar S.U., Solid C.A., Ankers E. Quantifying a rare disease in administrative data: The example of calciphylaxis. J Gen Intern Med. 2014;29:S724–S731.

Source: PubMed

Sponsorit ja yhteistyökumppanit

Sairaudet

Huumeiden interventiot

3
Tilaa