Calciphylaxis: Natural history, risk factor analysis, and outcome

Background Calciphylaxis is characterized by ischemic cutaneous ulceration, high mortality, and ineffective treatment. Methods We conducted a retrospective study of 64 patients with calciphylaxis (including 49 dialysis patients age- and sex-matched to 98 dialysis controls). Results The estimated 1-y...

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Bibliographic Details
Published in:Journal of the American Academy of Dermatology 2007-04, Vol.56 (4), p.569-579
Main Authors: Weenig, Roger H., MD, Sewell, Lindsay D., MD, Davis, Mark D.P., MD, McCarthy, James T., MD, Pittelkow, Mark R., MD
Format: Article
Language:English
Subjects:
Adult
Age Distribution
Aged
Aged, 80 and over
Anti-Bacterial Agents - therapeutic use
Biological and medical sciences
Calciphylaxis - diagnosis
Calciphylaxis - mortality
Calciphylaxis - therapy
Case-Control Studies
Cause of Death
Combined Modality Therapy
Debridement - methods
Dermatology
Factor Analysis, Statistical
Female
Humans
Kidney Failure, Chronic - diagnosis
Kidney Failure, Chronic - therapy
Logistic Models
Male
Medical sciences
Middle Aged
Parathyroidectomy - methods
Proportional Hazards Models
Rare Diseases
Reference Values
Renal Dialysis
Retrospective Studies
Risk Factors
Severity of Illness Index
Sex Distribution
Survival Analysis
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Summary:Background Calciphylaxis is characterized by ischemic cutaneous ulceration, high mortality, and ineffective treatment. Methods We conducted a retrospective study of 64 patients with calciphylaxis (including 49 dialysis patients age- and sex-matched to 98 dialysis controls). Results The estimated 1-year survival rate of calciphylaxis was 45.8%. Risk factors for calciphylaxis included obesity, liver disease, systemic corticosteroid use, calcium-phosphate product more than 70 mg2 /dL2 , and serum aluminum greater than 25 ng/mL. Survival rates were similar for 16 patients who received parathyroidectomy and 47 who did not. An estimated 1-year survival rate of 61.6% was observed for 17 patients receiving surgical debridement compared with 27.4% for the 46 who did not ( P = .008). Limitations The study was limited by its retrospective design and there was no control group for the 15 nondialysis cases. Conclusions Calciphylaxis is multifactorial and usually fatal. Prevention of calciphylaxis may include correction of risk factors identified in this study. Surgical debridement was associated with improved survival, but parathyroidectomy was not.
ISSN:0190-9622
1097-6787
DOI:10.1016/j.jaad.2006.08.065