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