Calciphylaxis responsive to lanthanum carbonate (FOSRENOL) therapy

Area of Science:

• Nephrology
• Vascular Biology
• Pharmacology

Background:

• Calciphylaxis is a severe vasculopathy linked to renal failure, characterized by vascular calcification.
• Elevated parathyroid hormone, hypercalcemia, and hyperphosphatemia are implicated in its pathogenesis.
• Current treatments targeting vascular mineralization show varied success.

Observation:

• A patient with acute kidney injury and biopsy-proven calciphylaxis presented with persistent, treatment-refractory hyperphosphatemia and hypercalcemia.
• The patient required dialysis and had a high calcium-phosphorus product.
• Standard therapies for mineralization were ineffective.

Findings:

• Lanthanum carbonate, a non-calcium-based phosphate binder, was initiated.
• The patient demonstrated a rapid clinical response to lanthanum carbonate therapy combined with modified dialysis.
• This represents the first reported case of calciphylaxis successfully treated with lanthanum carbonate.

Implications:

• Lanthanum carbonate may be a valuable therapeutic option for calciphylaxis, particularly in cases refractory to other treatments.
• Targeting phosphate binders is crucial in managing complex mineral metabolism disorders in renal disease.
• Further research is warranted to explore the efficacy and safety of lanthanum carbonate in calciphylaxis management.