Calciphylaxis is a rare condition where an excess of calcium forms in a person’s blood vessels and arteries. This buildup can cause clotting and result in severely painful skin lesions.
Calciphylaxis usually occurs in people with kidney disease.
It can be a serious condition that can have a high mortality rate. A person who believes they have calciphylaxis should consult a doctor to receive prompt diagnosis and treatment.
In this article, we explore the symptoms and causes of calciphylaxis. We also examine the condition’s complications and how doctors diagnose and treat it.
A note about sex and gender
Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.
Common signs and symptoms of calciphylaxis may include:
- skin abnormalities
- calcium buildup in the blood vessels and arteries
- cellulitis
- discoloration of the skin
- the formation of bone in soft tissues
- gangrene
- skin ulcers or open sores and lesions
- intense pain
At times, a person may also develop:
- vision problems
- internal bleeding
- muscle damage
These symptoms can vary from person to person and in severity. In severe cases, the condition can have a very high mortality rate.
Symptoms of kidney disease
A person usually develops calciphylaxis because they have kidney disease, which may go without detection in its early stages. However, symptoms of late stage kidney disease may include:
- weight loss
- loss of appetite
- swelling in the:
- breathing difficulties
- fatigue
- sleeping difficulties such as insomnia
- an increased need to urinate
- blood present in the urine
- nausea
- headaches
- itchy skin
- muscle cramps
- erectile dysfunction
Researchers do not know the exact cause of calciphylaxis. However, it generally occurs due to a buildup of calcium in the blood vessels. This buildup could result from a disruption in how the body mineral metabolizes certain minerals.
A 2018 review suggests that dialysis-dependent individuals, such as those with kidney disease, have mineral metabolism disruption, which may cause calcium buildup.
Research suggests that a person may be
Individuals who have the following conditions may also be more likely to develop calciphylaxis:
- kidney disease
- obesity
- diabetes
- hypoalbuminemia, or low levels of albumin
- autoimmune disorders, such as:
- lupus
- rheumatoid arthritis
- antiphospholipid antibody syndrome, an immune disorder involving atypical antibodies that may have links to blood clots
- liver disease
- cancer
- dialysis vintage
Medications
Some medications may increase a person’s risk of developing calciphylaxis, such as:
- warfarin
- corticosteroids
- calcium-based phosphate binders
- activated vitamin D
- iron therapies
The most common reason for developing calciphylaxis may be advanced kidney failure. Calciphylaxis occurs in around
One complication of calciphylaxis may be intense pain due to lesions and ulcers on the skin. These complications could result in a person having
In addition, the skin lesions may not heal. They may also result in infections, which can occur due to open wounds and usually affect the blood.
Sepsis is also possible due to calciphylaxis. It occurs when a person’s body attacks tissues and organs in response to another infection. Sepsis can be life threatening.
People should consult a doctor immediately if they think they may have calciphylaxis.
Doctors may review a person’s medical history, ask for further information about symptoms, and perform a physical examination.
Researchers in 2019 suggested a person with end stage renal disease may receive a diagnosis of calciphylaxis if they present with ulcers on the skin.
Diagnostic tools
A person may require a biopsy of one of their lesions to rule out other similar conditions. Alternatively, a medical professional may carry out a biopsy if a person is in the early stages of renal disease.
However, biopsies can sometimes aggravate the ulcers and cause bleeding or an infection. This is why some medical professionals may occasionally choose not to perform one if they are confident of their diagnosis.
Blood tests can also show levels of calcium in the blood. Additionally, X-rays may display any calcium deposits in the body.
There are
The goal of treatment involves:
- optimizing wound management
- stopping the progression of vessel wall calcification
- reversing vessel wall calcification
Medication
Doctors used cinacalcet to treat high calcium levels in hyperparathyroidism in people receiving long-term dialysis for kidney disease. Hyperparathyroidism refers to the overactive functioning of the parathyroid glands.
Cinacalcet usually comes in tablet form, and a person takes it orally. A
A 2019 review stated that sodium thiosulfate is a common calciphylaxis treatment — doctors gave it to 50.3% of people with the condition. While it does not have approval from the Food and Drug Administration (FDA), doctors may prescribe it off-label to help reduce calcium buildup in the arteries.
Additionally, doctors may administer sodium thiosulfate intravenously into a vein during a dialysis session.
Wound care
A person may receive antibiotics for their wounds to prevent infection. Additionally, a healthcare professional may dress the wounds if necessary.
Doctors may use debridement to remove dead tissue from the wounds. This procedure may occasionally involve surgery.
Learn more about open wound care.
Hyperbaric oxygen therapy
Hyperbaric oxygen therapy may promote wound healing. It involves the wounds receiving exposure to oxygen at a much higher pressure than usual. This helps speed up the healing process.
A
Kidney transplant
Some research presents three case studies of individuals who received an urgent kidney transplant after developing calciphylaxis. The patients all had stage 5 kidney failure.
All three individuals recovered from calciphylaxis after their transplant.
The
The earlier a doctor diagnoses a person’s symptoms, the sooner they can start treatment to improve outcomes.
There are limited preventive treatments once a person has end stage kidney disease.
Medical professionals may monitor and attempt to control the mineral and calcium levels in someone with end stage kidney disease to avoid calciphylaxis.
Doctors can also educate and screen people at risk for developing calciphylaxis to help prevent it.
Calciphylaxis is a rare and severe condition that affects people with end stage renal disease. It usually results in severely painful lesions on the skin that may result in infection.
The mortality rate is high in people with calciphylaxis. However, treatment options may help promote wound healing and manage pain. However, limited preventive treatments exist for individuals who enter end stage renal disease.
People should seek prompt medical attention if they think they may have calciphylaxis. This helps rule out other conditions and facilitates early treatment for more positive outcomes.