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Calciphylaxis is a rare condition usually seen in patients with kidney failure. Patients with calciphylaxis experience localized death of skin and fatty tissue as a result of changes in the walls of their blood vessels. This condition can be fatal and there is no standardized approach to treatment. Patients in kidney failure should be monitored closely for physical changes that might indicate the onset of calciphylaxis, and their diet should be controlled to avoid risk factors for the disease.
In patients with kidney failure, the kidneys have difficulty expressing phosphate. This causes blood levels of phosphate to rise. The compound binds with calcium, and leads to deposition of calcium in the walls of the small blood vessels, a situation known as vascular calcification. Changes in the structure of the cell walls is associated with blood clots. The small blood clots impede the flow of blood to skin and fatty tissue, causing it to die. Calciphylaxis can be associated with hyperparathyroidism, which is when the body overproduces the parathyroid hormone, causing blood chemistry to become even more skewed.
The first sign of calciphylaxis is usually a reddish to purple blotch on the skin. Over time, the blotch develops into a dark area of ulcerated tissue. The patient usually experiences tingling, numbness, itching, and burning at the site. Because many conditions can cause tissue death, a biopsy is commonly recommended to check for signs of conditions such as necrotizing fasciitis. A pathologist examining the specimen will be able to see the increased levels of calcium that characterize calciphylaxis.
Treatment includes management of the wounds, along with changes to the patient's diet to limit the deposition of excess calcium. If a patient has hyperparathyroidism, medical or surgical treatment may be recommended to address the high levels of parathyroid hormone. Debridement of the ulcers is used to remove dead tissue for the purpose of limiting infection and inflammation. A wound care specialist may be consulted to provide a high level care to the patient, including treatment for the pain associated with the ulcerations.
This condition is also known as calcific uremic arteriolopathy. Some methods to prevent the onset of calciphylaxis include monitoring blood chemistry closely and adjusting the patient's treatment and diet to address abnormal levels, along with treating kidney failure aggressively. Kidney failure is associated with a number of other complications and it is advisable to receive treatment under the supervision of a nephrologist, which is a medical specialist who focuses on kidney care.