Calciphylaxis in the Setting of Hemodialysis, Liver Cirrhosis, and Warfarin Therapy for Atrial Fibrillation: An Argument for Alternative Anti-Embolic Therapy

Medepalli, Vidya M.; Davis, Loretta S.; Medepalli, Lalitha C.; Padala, Sandeep

doi:10.7759/cureus.8014

Cited by 3 publications

(2 citation statements)

References 18 publications

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“…The transition from peritoneal dialysis to hemodialysis and the use of intensive hemodialysis is recommended as this may advance wound healing through better control of mineral metabolism. 19 Dialysis vintage before CUA diagnosis was 895 days in keeping with other studies which have ranged from 621 to 3225 days. 1,7,13,14 Being overweight or obese and having diabetes are also common risk factors identified in our and previous studies.…”

Section: Discussionsupporting

confidence: 83%

Characterization of Risk Factors for Calciphylaxis in Hemodialysis Patients in the Fraser Health Renal Program – A Matched Case-Control Retrospective Review

Jang

Yan

2022

Journal of Pharmacy Practice

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Introduction Calciphylaxis is a lethal and rare disease characterized by ischemic and necrotic skin lesions caused by vascular calcification of adipose tissue. There have been many risk factors analyzed in the literature; however, the pathogenesis of calciphylaxis is still not well understood and treatment options are limited due to the lack of interventional studies. Our objectives were to describe risk factors, prevalence, incidence, and outcomes for calciphylaxis in hemodialysis patients within the Fraser Health Renal Program. Methods This was a retrospective matched case-control study of hemodialysis patients within the Fraser Health Renal Program. Hemodialysis patients with calciphylaxis were matched to hemodialysis patients without calciphylaxis in a 1:2 ratio for age and sex from September 2, 2017 to July 3, 2020. Findings There was a total of 40 calciphylaxis cases matched to 80 controls. In the univariate analysis, peritoneal dialysis, higher body mass index, lower serum iron, lower transferrin saturation, sevelamer, cinacalcet, warfarin, iron (PO), and insulin were associated with increased risk of calciphylaxis. In the multivariate analysis, only peritoneal dialysis, serum iron, sevelamer, and warfarin were identified as significant and strong risk factors associated with calciphylaxis. A low prevalence of 1.9% and high mortality rate of 57.5% at 12 months was found for calciphylaxis cases. Discussion Significant risk factors associated with calciphylaxis were peritoneal dialysis, serum iron, sevelamer, and warfarin. Future studies should further investigate the impact of minimizing exposure to these risk factors to reduce calciphylaxis development.

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Section: Discussionsupporting

confidence: 83%

Characterization of Risk Factors for Calciphylaxis in Hemodialysis Patients in the Fraser Health Renal Program – A Matched Case-Control Retrospective Review

Jang

Yan

2022

Journal of Pharmacy Practice

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“…It occurs when vascular calcinosis causes ischemia and necrosis of the skin, subcutaneous fat, and other organs. 8 , 9 Studies have shown that 40% to 80% of adults on maintenance dialysis have soft tissue calcinosis and has an incidence of 0.5% to 3%. 10 - 12 The calcification of internal visceral organs is clinically more insidious and rarely recognized before death.…”

Section: Discussionmentioning

confidence: 99%

Metastatic Calcinosis of Gastric Mucosa

Kosuru

Mohammed

Kapoor

et al. 2020

Journal of Investigative Medicine High Impact Case Reports

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Calcinosis cutis refers to the deposition of calcium salts in the cutaneous and subcutaneous tissue and is frequently associated with inflammation. Gastric calcinosis can be classified into metastatic, dystrophic, and idiopathic; metastatic calcinosis is the most common type. In metastatic calcification, calcium salts are deposited in normal soft tissues in the setting of altered metabolism of serum calcium and phosphorus and is a rare and serious complication of chronic renal failure. The important factors contributing to the development of metastatic calcinosis are hypercalcemia, hyperphosphatemia, and an elevated calcium-phosphate product. The most striking feature of this diagnosis is the calcification around the large joints. While it mostly involves dermis of small and medium-sized vessels, it can rarely affect the mucosal layers of the gastrointestinal (GI) tract. Calcinosis presents as a marker for the presence of calcifications in other organs, such as heart or lung, which can be life-threatening. Patients rarely present with clinical symptoms of GI upset, dyspepsia, or epigastric pain that are attributed to calcinosis. If patients present with GI symptoms, infectious causes remain to be higher on the differential. We present a case of incidental finding of gastric mucosal calcinosis during the workup and treatment of dysphagia.

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Anticoagulant-associated calciphylaxis: analysis of USFDA adverse event report system and clinical feature analysis of reported cases

Sridharan,

Sivaramakrishnan

2024

Expert Opinion on Drug Safety

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Calciphylaxis in the Setting of Hemodialysis, Liver Cirrhosis, and Warfarin Therapy for Atrial Fibrillation: An Argument for Alternative Anti-Embolic Therapy

Cited by 3 publications

References 18 publications

Characterization of Risk Factors for Calciphylaxis in Hemodialysis Patients in the Fraser Health Renal Program – A Matched Case-Control Retrospective Review

Characterization of Risk Factors for Calciphylaxis in Hemodialysis Patients in the Fraser Health Renal Program – A Matched Case-Control Retrospective Review

Metastatic Calcinosis of Gastric Mucosa

Anticoagulant-associated calciphylaxis: analysis of USFDA adverse event report system and clinical feature analysis of reported cases

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