Calciphylaxis

calcific uremic arteriopathy, NEJM 2018;378:1704)

詳見Calciphylaxis.

• Pathophys: calcification of media in dermal small- to med-sized blood vessels & SC fat → ischemia and skin necrosis w/ painful lesions (NEJM 2007;356:1049)

詳見Case records of the Massachusetts General Hospital. Case 7-2007. A 59-year-old

• Risk factors: ESRD, ♀>♂, DM, vit K def, obesity, warfarin, local trauma, thrombophilias

• Dx: skin bx, but limitations (Kidney Int 2018;94:390); bone scan used in support of dx

• Rx: ↓ risk factors, wound care/surgical debridement, manage hyperPTH, d/c vit D, Ca, & warfarin (DOAC okay). Pain control, palliative care, ? Na thiosulfate.

• Prognosis: 60% 1-y mortality in ESRD Pts (AJKD 2015;66:133)

詳見Advance care planning and end-of-life decision making in dialysis: a randomized

qv: hypercalcemia