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Calciphylaxis in children: a case series and systematic review
Jun Li1, Shilei Jia1, Yijiao Ma1
1Department of Nephrology, Shenzhen Children's Hospital, Shenzhen, Guangdong, China.
Pediatric Nephrology (Berlin, Germany)
|July 11, 2026
Summary
Pediatric calciphylaxis is a rare vascular disorder primarily affecting children with end-stage renal disease. Early recognition and aggressive treatment, including sodium thiosulfate, are crucial for survival.
Area of Science:
- Vascular Biology
- Pediatric Nephrology
- Dermatology
Background:
- Calciphylaxis is a rare, life-threatening vascular calcification disorder with limited pediatric data.
- Characterized by microvessel occlusion and skin necrosis, it poses significant challenges in children.
Purpose of the Study:
- To systematically review and analyze pediatric calciphylaxis cases.
- To identify risk factors, treatment modalities, and outcomes in children.
Main Methods:
- Systematic literature search of PubMed, Web of Science, and Embase up to January 2026.
- Inclusion of studies on patients ≤18 years old, supplemented by two institutional cases.
- Analysis of 19 pediatric patients, with a mean age of 10.5 years.
Main Results:
- End-stage renal disease (ESRD), secondary hyperparathyroidism, and hyperphosphatemia were primary risk factors.
- Intravenous sodium thiosulfate (STS) and calcium-phosphate control showed effectiveness.
- Overall calciphylaxis-specific mortality was 26%, higher in treatment-refractory cases.
Conclusions:
- Pediatric calciphylaxis predominantly affects children with ESRD and associated metabolic derangements.
- Early diagnosis and multimodal management are critical due to high mortality.
- Sodium thiosulfate (STS) therapy may be associated with improved survival, though not statistically significant in this cohort.
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