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Updated: Feb 24, 2026

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[Calciphylaxis].

Nicolás Raimondi1, Jorge J Del Vecchio1, Mauricio Ghioldi1

  • 1Departamento de Ortopedia y Traumatología, Hospital Universitario, Fundación Favaloro, Buenos Aires, Argentina.

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Summary

Calciphylaxis, a severe skin condition often seen in kidney failure patients, causes painful necrosis. Sodium thiosulfate shows promise as a treatment option for this challenging vasculopathy.

Keywords:
calciphylaxischronic renal failuredebridementskin necrosissodium thiosulfatevasculopathy

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Area of Science:

  • Nephrology
  • Dermatology
  • Vascular Medicine

Background:

  • Calciphylaxis is a rare and severe vasculopathy affecting patients with end-stage renal disease.
  • It is characterized by calcification and thrombosis in small blood vessels, leading to skin necrosis and high mortality.
  • Diagnosis typically relies on skin biopsy, with no specific laboratory markers.

Observation:

  • Patients often present with painful, purplish skin mottling, resembling livedo reticularis, primarily on the extremities.
  • Lesions progress to non-healing ulcers and bedsores, significantly impacting patient quality of life.
  • Two clinical cases illustrating the presentation and management of calciphylaxis are presented.

Findings:

  • Skin biopsy confirms calcification and fibroplasia in the panicular arterioles.
  • While standard care includes wound management and antibiotics, sodium thiosulfate is explored for its antioxidant and chelating properties.
  • The reported cases highlight the clinical course and potential therapeutic avenues.

Implications:

  • Early recognition and diagnosis of calciphylaxis are crucial for timely intervention.
  • Sodium thiosulfate represents a potential therapeutic agent for calciphylaxis, warranting further investigation.
  • Improved management strategies are needed to reduce the high mortality associated with this condition.