Summary
Objective. The aim is to analyse the scientific literature and provide evidence-based information on calciphylaxis in patients with chronic kidney disease, presenting the most important aspects.
Material and methods. A literature search was performed in PubMed and Google Scholar databases. Keywords used in English: chronic kidney disease, end-stage renal disease, calciphylaxis, calcific uremic arteriolopathy. The analysis included articles published in the last 10 years.
Results. The incidence of chronic kidney disease is rising globally, along with more disease-related complications. Calciphylaxis is a rare life-threatening complication with unclear causes, but linked to elevated parathyroid hormone, calcium and phosphate levels, activated vitamin D use and lack of vascular calcification inhibitors. Calcification is a significant process, which causes endothelial dysfunction and microthrombus formation. Symptoms include proximal subcutaneous nodules, poorly healing, painful skin lesions complicated by infections. Calciphylaxis is more common in women, elderly and white individuals. Metabolic disorders, hyperparathyroidism, cardiovascular disease, hemodialysis duration and certain drugs are key risk factors. The gold standard for diagnosis is skin biopsy. Sodium thiosulphate is a promising therapy, though no specific treatment exists.
Conclusions. Calciphylaxis is a rare condition that occurs in patients with end-stage chronic kidney disease and treated with haemodialysis, characterised by painful skin lesions of various localisations, caused by elevated parathyroid hormone, calcium, phosphate levels, activated vitamin D use, and lack of vascular calcification inhibitors. Although chronic kidney disease and calciphylaxis are increasing, no specific effective treatment or standardised diagnostic method exist.
