Aim: Calciphylaxis is a rare disease, predominantly in chronic kidney disease (CKD), characterized by high morbidity and mortality. Data from the Chinese population have been an invaluable resource for a better understanding of natural history, optimal treatments and outcomes of calciphylaxis.Methods: A retrospective study was conducted in 51 Chinese patients diagnosed with calciphylaxis at Zhong Da Hospital affiliated to Southeast University from December 2015 to September 2020.Results: Between 2015 and 2020, 51 cases of calciphylaxis were registered in The China Calciphylaxis Registry (http://www.calciphylaxis.com.cn), which was developed by Zhong Da Hospital. The mean age of the cohort was 52.02 ± 14.09 years, and 37.3% were female. Forty-three patients (84.3%) were on haemodialysis, with a median dialysis vintage of 88 months. Eighteen patients (35.3%) had a resolution of calciphylaxis and 20 patients (39.2%) died. Patients in later stages had higher overall mortality than those in earlier stages. Delay from skin lesions onset to diagnosis and calciphylaxis-related infections were risk factors in both early and overall mortality.Additionally, dialysis vintage and infections were significant risk factors in calciphylaxis-specific mortality. Among therapeutic strategies, only the use of sodium thiosulfate (STS) ≥3 courses (14 injections) was significantly associated with decreased hazard of death in both early and overall mortality. Conclusion:For Chinese patients with calciphylaxis, delay from skin lesions onset to diagnosis and infections secondary to wounds are risk factors for the prognosis of patients with calciphylaxis. Additionally, patients in earlier stages have better survival and early continuous use of STS is highly suggested.

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Renal interstitial fibrosis (RIF) is the prominent pathological characteristics of deteriorative chronic kidney disease (CKD), leading to peritubular capillary (PTC) rarefaction accompanied by obvious hypoxia. However, the underlying mechanisms remain elusive. To deal with this, we constructed a comparative transcriptome analysis of hypoxia and normoxia induced HK-2 cells model to discover total 572 differentially expressed genes (DEGs), which were involved in extensive biological processes. Moreover, these DEGs were uncovered to regulate RIF mainly through HIF-1 signaling pathway from KEGG enrichment. Hence, chip sequencing of HK-2 hypoxia was used to identify 2915 favorable genes modulated by HIF-1α through peak annotation. To translate bioinformatic data into credible clinical application, 43 intersections were then found via a combination of RNA sequencing and chip sequencing. In addition to angiogenesis of GO analysis, 2 candidates including VEGFA and BTG1 were finally recommended as novel targets by annotating their binding sites, which significantly interacted with HIF-1α. Our study provided ascendant insights into the molecular mechanism’s alterations of RIF, therefore paving the intervention therapeutics.

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