User:Mr. Ibrahem/Calciphylaxis

Calciphylaxis is calcification of small blood vessels located within fatty tissue and the deeper layer of the skin. Symptoms generally include severe pain and skin changes. Often their are multiple areas of skin involvement, beginning as areas of thickening, that become purple in color, followed by the formation of an ulcer. Complications may include depression and sepsis.

It most commonly occurs in those with end-stage kidney disease; though can occur in earlier stage chronic kidney disease or acute kidney injury. Rarely it may occur in those with normal kidney function. Other risk factors include obesity, diabetes, cancer, certain medications including warfarin and vitamin D, and areas of tissue injury. The underlying mechanism involves narrowing of small blood vessels followed by blood clots and the death of skin cells due to too little blood flow. Diagnosis may be made based on symptoms; though can be confirmed by skin biopsy.

Treatment may involved increased dialysis frequency, stopping calcium supplements, and sodium thiosulfate. For those with high parathyroid hormone, cinacalcet should be used instead of activated vitamin D. Other important efforts include wound care and pain management. Hyperbaric oxygen therapy may help some people. Outcomes are generally poor, with a typical life expectancy of less than one year. The cause of death is most often sepsis.

Calciphylaxis is rare, affecting about 4 to 400 per 10,000 people on dialysis per year. Women are more commonly affected than men and all ages may be involved. The condition was first described in 1898 by White and Bryant. The importance of the condition was determined in 1976 by Gipstein.