Calciphylaxis: Natural history, risk factor analysis, and outcome - 12/08/11
, Lindsay D. Sewell, MD a, 
, Mark D.P. Davis, MD a, James T. McCarthy, MD b, Mark R. Pittelkow, MD aReprint requests: Roger H. Weenig, MD, Department of Dermatology, Mayo Clinic, 200 First St SW, Rochester, MN 55905.Rochester, Minnesota
Abstract |
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.
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| Funding sources: None. Conflicts of interest: None identified. |
Vol 56 - N° 4
P. 569-579 - aprile 2007 Ritorno al numero
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