Nonuremiccalciphylaxis - A Systematic Review

Background: Calciphylaxis, also known as calcific uremic arteriolopathy, is a well-described condition in renal transplant and end-stage kidney disease (ESKD) patients; however, little is known about calciphylaxis induced by nonuremic causes. This systematic study aimed to determine the causes, prognosis of nonuremic calciphylaxis, clinical features and laboratory abnormalities.

Patients and methods:A comprehensive review of the literature for nonuremic calciphylaxis case reports and case series published between 2016 and 2021 was performed. Cases included satisfied the criteria for a histological diagnosis of nonuremic calciphylaxis in the absence of ESKD, renal transplantation, or acute kidney injury requiring renal replacement therapy.

Results: The authors identified 53 cases of nonuremic calciphylaxis (83.14 % women, Caucasian 13.33 %, aged 25 to 83 years). The most prevalent documented associations were of patients having multiple conditions 18 (33.33 %), warfarin-induced (7.4 %), calcium and Vitamin D supplementation (3.7 %), primary hyperparathyroidism (3.7 %), liver disease (3.7 %), Acenocumarol use (3.7 %), Systematic lupus erythematosus (3.7 %), alcoholic cirrhosis (3.7 %), respectively.

Conclusion:When investigating skin lesions in patients with sensitive conditions, calciphylaxis must often be addressed in the absence of ESKD or renal transplantation. Obese women with various underlying illnesses such as alcohol intake, smoking, diabetes, liver disease, and so on are more likely to develop nonuremic calciphylaxis (NUC).Calciphylaxis is linked with high mortality; however, sodium thiosulfate (ST) has made clear progress in terms of treatment, yet there are still areas that need to be addressed to describe the effectiveness of ST.