Calcific uraemic arteriolopathy (calciphylaxis) in patients on renal replacement therapy

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dc.contributor.authorSebastian, S.en_ZA
dc.contributor.authorJordaan, H. F.en_ZA
dc.contributor.authorSchneider, J. W.en_ZA
dc.contributor.authorMoosa, M. R.en_ZA
dc.contributor.authorDavids, M. R.en_ZA
dc.date.accessioned2019-02-28T10:05:07Z
dc.date.available2019-02-28T10:05:07Z
dc.date.issued2017
dc.descriptionCITATION: Sebastian, S., et al. 2017. Calcific uraemic arteriolopathy (calciphylaxis) in patients on renal replacement therapy. South African Medical Journal, 107(2):140-144, doi:10.7196/SAMJ.2017.v107i2.11058.
dc.descriptionThe original publication is available at http://www.samj.org.za/index.php/samj
dc.description.abstractBackground. Calcific uraemic arteriolopathy (calciphylaxis) is an unusual and potentially fatal condition characterised by small-vessel calcification and ischaemic skin necrosis. It mainly affects patients with end-stage renal disease (ESRD) on haemodialysis, but may rarely occur in the absence of ESRD in conditions such as primary hyperparathyroidism, malignancy, alcoholic liver disease and connective tissue disease. Methods. We reviewed the records of all patients diagnosed with calciphylaxis while on renal replacement therapy at Tygerberg Hospital, Cape Town, South Africa, between 1990 and 2014, to describe its presentation, course and final outcome. Results. Nineteen patients developed calciphylaxis over this period. Their median age was 34 years and 13 (68.4%) were female. Fifteen (78.9%) had received a kidney transplant. All patients had painful skin lesions that rapidly progressed to infarction. Small-vessel calcification was seen on skin biopsy in 13 patients. Twelve patients had hyperparathyroidism. Several of the transplanted patients had been treated for graft rejection in the year preceding the diagnosis. Treatment consisted of good wound care and efforts to normalise serum calcium and phosphate levels. Five patients received an urgent parathyroidectomy. The outcome was fatal in 17 patients, with sepsis being the main cause of death. Conclusions. In our patients, calciphylaxis carried a worse prognosis than previously reported internationally. It should always be considered in the differential diagnosis of painful skin lesions in the dialysis or transplant patient.en_ZA
dc.description.urihttp://www.samj.org.za/index.php/samj/article/view/11810
dc.description.versionPublisher's version
dc.format.extent5 pages
dc.identifier.citationSebastian, S., et al. 2017. Calcific uraemic arteriolopathy (calciphylaxis) in patients on renal replacement therapy. South African Medical Journal, 107(2):140-144, doi:10.7196/SAMJ.2017.v107i2.11058
dc.identifier.issn2078-5135 (online)
dc.identifier.issn0256-9574 (print)
dc.identifier.otherdoi:10.7196/SAMJ.2017.v107i2.11058
dc.identifier.urihttp://hdl.handle.net/10019.1/105491
dc.language.isoen_ZAen_ZA
dc.publisherHealth and Medical Publishing Group
dc.rights.holderAuthors retain copyright
dc.subjectCalcificationen_ZA
dc.subjectChronic renal failureen_ZA
dc.subjectCalciphylaxisen_ZA
dc.subjectDialysisen_ZA
dc.titleCalcific uraemic arteriolopathy (calciphylaxis) in patients on renal replacement therapyen_ZA
dc.typeArticleen_ZA
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