Calciphylaxis: Risk Factors, Diagnosis, and Treatment

被引:280
|
作者
Nigwekar, Sagar U. [1 ]
Kroshinsky, Daniela [2 ]
Nazarian, Rosalynn M. [3 ]
Goverman, Jeremy [4 ]
Malhotra, Rajeev [5 ]
Jackson, Vicki Ann [6 ]
Kamdar, Mihir M. [6 ]
Steele, David J. R. [1 ]
Thadhani, Ravi I. [1 ]
机构
[1] Massachusetts Gen Hosp, Div Nephrol, Boston, MA 02114 USA
[2] Massachusetts Gen Hosp, Dept Dermatol, Boston, MA 02114 USA
[3] Massachusetts Gen Hosp, Dermatopathol Unit, Pathol Serv, Boston, MA 02114 USA
[4] Massachusetts Gen Hosp, Dept Surg, Burn Serv, Boston, MA 02114 USA
[5] Massachusetts Gen Hosp, Div Cardiol, Boston, MA 02114 USA
[6] Massachusetts Gen Hosp, Palliat Care Div, Boston, MA 02114 USA
关键词
Calcific uremic arteriolopathy; calciphylaxis; risk factors; sodium thiosulfate; warfarin; review; CALCIFIC UREMIC ARTERIOLOPATHY; TISSUE-PLASMINOGEN ACTIVATOR; SODIUM THIOSULFATE THERAPY; HYPERBARIC-OXYGEN THERAPY; NONUREMIC CALCIPHYLAXIS; CUTANEOUS CALCIPHYLAXIS; VASCULAR CALCIFICATION; PROXIMAL CALCIPHYLAXIS; CHEMICAL PERITONITIS; 1ST-LINE TREATMENT;
D O I
10.1053/j.ajkd.2015.01.034
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Calciphylaxis is a rare but devastating condition that has continued to challenge the medical community since its early descriptions in the scientific literature many decades ago. It is predominantly seen in patients with chronic kidney failure treated with dialysis (uremic calciphylaxis) but is also described in patients with earlier stages of chronic kidney disease and with normal kidney function. In this review, we discuss the available medical literature regarding risk factors, diagnosis, and treatment of both uremic and nonuremic calciphylaxis. High-quality evidence for the evaluation and management of calciphylaxis is lacking at this time due to its rare incidence and poorly understood pathogenesis and the relative paucity of collaborative research efforts. We hereby provide a summary of recommendations developed by a multidisciplinary team for patients with calciphylaxis. (C) 2015 by the National Kidney Foundation, Inc.
引用
收藏
页码:133 / 146
页数:14
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