Retrospective Analysis of Tissue Plasminogen Activator as an Adjuvant Treatment for Calciphylaxis

el-Azhary, Rokea A.; Arthur, Allison K.; Davis, Mark D.P.; McEvoy, Marian T.; Gibson, Lawrence E.; Weaver, Amy L.; Camilleri, Michael; Wetter, David A.; Weenig, Roger H.

doi:10.1001/2013.jamadermatol.5

Cited by 38 publications

(28 citation statements)

References 20 publications

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“…A recent analysis of tissue plasminogen activator as an adjunctive therapy did not show a survival benefit. It did show variable degrees of wound healing but with some significant risks (93). More data are needed to assess the use of tissue plasminogen activator.…”

Section: Metastatic Calcificationmentioning

confidence: 99%

Cutaneous Manifestations of ESRD

Galperin

Cronin

Leslie

2014

Clinical Journal of the American Society of Nephrology

193

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SummaryA broad range of skin diseases occurs in patients with ESRD: from the benign and asymptomatic to the physically disabling and life-threatening. Many of them negatively impact on quality of life. Their early recognition and treatment are essential in reducing morbidity and mortality. The cutaneous manifestations can be divided into two main categories: nonspecific and specific. The nonspecific manifestations are commonly seen and include skin color changes, xerosis, half-and-half nails, and pruritus. The specific disorders include acquired perforating dermatosis, bullous dermatoses, metastatic calcification, and nephrogenic systemic fibrosis. This review article describes these conditions and considers the underlying pathophysiology, clinical presentations, diagnosis, and treatment options.

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Section: Metastatic Calcificationmentioning

confidence: 99%

Cutaneous Manifestations of ESRD

Galperin

Cronin

Leslie

2014

Clinical Journal of the American Society of Nephrology

193

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“…These include bisphosphonates, low-dose tissue plasminogen activator infusion, LDL-apheresis, vitamin K, and kidney transplantation. 51,118-125 In our opinion, these modalities may be considered on a case-by-case basis taking into account the cost, availability, and patient-related factors with clear understanding of the limitations of the available data.…”

Section: Treatmentmentioning

confidence: 99%

Calciphylaxis: Risk Factors, Diagnosis, and Treatment

Nigwekar

Kroshinsky

Nazarian

et al. 2015

American Journal of Kidney Diseases

365

505

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Calciphylaxis is a rare but devastating condition that has continued to challenge the medical community since its early descriptions in the scientific literature many decades ago. It is predominantly seen in chronic kidney failure patients treated with dialysis (uremic calciphylaxis) but is also described in patients with earlier stages of chronic kidney disease and with normal renal function. In this In Practice feature, we review the available medical literature regarding risk factors, diagnosis, and treatment of both uremic and non-uremic calciphylaxis. High quality evidence for the evaluation and management of calciphylaxis is lacking at this time due to its rare incidence, poorly understood pathogenesis, and the relative paucity of collaborative research efforts. We hereby provide a summary of recommendations developed by the Massachusetts General Hospital's Multi-disciplinary Calciphylaxis Team for calciphylaxis patients.

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“…Treatment is based on general supportive therapy and strategies to correct potential pathogenic mechanisms (1,2,5,7,18,19). General management includes discontinuing potential causes while providing metabolic and nutritional support.…”

Section: Discussionmentioning

confidence: 99%

Calciphylaxis in Simultaneous Liver–Kidney Transplantation

Bohórquez

Chamorro

Garces

et al. 2015

American Journal of Transplantation

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We present four patients who underwent simultaneous liver-kidney transplantation (SLK) and were diagnosed with calciphylaxis, also known as calcific uremic arteriolopathy (CUA). Common characteristics included high MELD scores (mean 35.2 AE 4.8) and advanced renal disease (duration range 6-44 weeks). CUA was diagnosed within the first 2 months post-SLK based on clinical features. Severe morbidity and prolonged hospital stay were observed and one of the patients died secondary to sepsis. Treatment included metabolic support, wound care, calcium level correction and use of sodium thiosulphate. CUA should be considered in the presence of painful dermatologic changes in patients status post SLK.

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Retrospective Analysis of Tissue Plasminogen Activator as an Adjuvant Treatment for Calciphylaxis

Cited by 38 publications

References 20 publications

Cutaneous Manifestations of ESRD

Cutaneous Manifestations of ESRD

Calciphylaxis: Risk Factors, Diagnosis, and Treatment

Calciphylaxis in Simultaneous Liver–Kidney Transplantation

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