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Management of patients with calciphylaxis: current perspectives

Authors Erfurt-Berge C, Renner R

Received 15 April 2019

Accepted for publication 19 July 2019

Published 17 October 2019 Volume 2019:6 Pages 109—115

DOI https://doi.org/10.2147/CWCMR.S182417

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 2

Editor who approved publication: Professor Marco Romanelli


Video abstract presented by Cornelia Erfurt-Berge.

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Cornelia Erfurt-Berge, Regina Renner

Department of Dermatology, University Hospital Erlangen, Erlangen 91054, Germany

Correspondence: Cornelia Erfurt-Berge
Department of Dermatology, University Hospital Erlangen, Ulmenweg 18, Erlangen 91054, Germany
Tel + 49 9 131 853 5000
Email Cornelia.Erfurt-Berge@uk-erlangen.de

Abstract: Calciphylaxis (CP) is a rare disorder presenting with painful ischemic skin ulcerations. Its association with end-stage renal disease, but also non-uremic cases have been described. Several risk factors, like metabolic syndrome, calcium-phosphate imbalance, anticoagulative medication and female gender have been discussed. Multidisciplinary therapeutic approaches are necessary since evidence-based guidelines are missing due to lack of pathophysiological understanding of the disease and the absence of studies with large patient cohorts. However, strategies for local wound therapy, reduction of risk factors and systemic therapies are being developed. Changes in duration, frequency and method of hemodialysis and specific medication to lower the calcium upload can be effective in uremic CP cases. Systemic treatments with cinacalcet, sodium thiosulfate or bisphosphonates have been applied successfully in CP patients, but large placebo-controlled randomized trials are still needed to gather better insight into this fatal disease.

Keywords: calciphylaxis, calcific uremic arteriolopathy, non-uremic calciphylaxis, calcification, treatment, sodium thiosulfate

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