Skin wounds associated with calciphylaxis in end-stage renal disease patients on dialysis

Abstract 

Calciphylaxis is a rare complication of chronic renal failure mostly with poor prognosis. Painful lesions on various skin surface areas are the most prominent feature of this serious disease. Subsequent infection of necrotic skin tissue is associated with the risk of sepsis. Pathophysiology is unclear, but several risk factors are known. The most important risk factor is impaired calcium-phosphate metabolism. Our paper describes two cases of different forms of calciphylaxis in patients with chronic renal failure. In the first case, pamidronate and cinacalcet were used for treatment. In the second described case, calciphylaxis was associated with secondary hyperparathyroidism and immediate subtotal parathyroidectomy was performed. Both patients were successfully treated, using systemic approach as well as dedicated local care for healing of skin wounds.

Keywords: Calciphylaxis, Calcific uremic arteriopathy, Chronic renal failure, Dialysis, Calcio-phosphate metabolism