Journal Article

Calciphylaxis in CKD and beyond

Vincent M. Brandenburg, Rafael Kramann, Paula Specht and Markus Ketteler

in Nephrology Dialysis Transplantation

Published on behalf of European Renal Association - European Dialysis and Transplant Assoc

Volume 27, issue 4, pages 1314-1318
Published in print April 2012 | ISSN: 0931-0509
Published online February 2012 | e-ISSN: 1460-2385 | DOI: http://dx.doi.org/10.1093/ndt/gfs015
Calciphylaxis in CKD and beyond

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Calciphylaxis is still an incompletely understood rare disease, which most often affects people on haemodialysis. For the majority of patients, calciphylaxis means a massive reduction in quality of life and is associated with high morbidity and mortality. We still know little about the concert of local and systemic risk factors and underlying causes that finally lead to the development of calciphylaxis. Recent work from Asia points towards persistent uncertainties in the diagnosis and management of the disease which the nephrology community has to address by establishing standards in both diagnosis as well as treatment strategies. Hayashi et al. have published results from a Japanese survey in which the authors collected data from calciphylaxis patients and compared clinical and laboratory data with those of control subjects. This innovative approach allowed the authors to calculate relative risks for various parameters in terms of calciphylaxis development. While uncontrolled hyperparathyroidism seemingly plays a secondary role, vitamin K antagonist usage proved to be of particular importance. Survey as well as registry data may help to close the gap in our knowledge about calciphylaxis which may ultimately result in improved prevention, patient care and outcome.

Keywords: calciphylaxis; parathyroid hormone; sodium thiosulphate; vitamin K; warfarin

Journal Article.  2834 words.  Illustrated.

Subjects: Nephrology

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