Risk Factors Associated With the Development of Calciphylaxis in Patients With Chronic Kidney Disease: A Systematic...

Area of Science:

• Nephrology
• Dermatology
• Vascular Biology

Background:

• Calciphylaxis, or calcific uremic arteriolopathy (CUA), is a rare, high-mortality disease.
• Pathogenesis involves calcium-phosphate dysregulation and arteriole calcification, primarily in chronic kidney disease (CKD) patients.
• Existing literature lacks structured risk profiling and focuses on diagnosis/treatment over risk factors.

Purpose of the Study:

• To systematically review and identify risk factors for calciphylaxis development in CKD patients.
• To address the gap in experimental and systematic reviews on calciphylaxis risk factors.
• To provide a foundation for structured risk profiling in calciphylaxis.

Main Methods:

• Systematic review of electronic databases (2018-2024) using keywords: calciphylaxis, chronic kidney disease, risk factors.
• Inclusion/exclusion criteria applied to 486 identified articles; quality assessment conducted.
• Data extraction from 16 eligible articles involving 1,739 patients.

Main Results:

• Dialysis emerged as the most frequent risk factor for calciphylaxis.
• Other identified risk factors: Caucasian ethnicity, female gender, obesity, diabetes mellitus, elevated parathyroid hormone, and use of vitamin K antagonists, vitamin D, and calcium phosphate binders.
• The reviewed studies were primarily observational, often single-centered with small sample sizes.

Conclusions:

• Dialysis is a significant risk factor for calciphylaxis in CKD patients.
• Multiple demographic and clinical factors contribute to calciphylaxis risk.
• Recommends large-scale, multicenter studies to establish robust risk profiling for calciphylaxis.