PMID: 11604339Oct 18, 2001Paper

Wet gangrene in hemodialysis patients with calciphylaxisis is associated with a poor prognosis

Cardiovascular Surgery : Official Journal of the International Society for Cardiovascular Surgery
C A Davis, R J Valentine

Abstract

Calciphylaxis is a rare syndrome characterized by progressive vascular calcification and ischemic tissue loss in patients with chronic renal failure. We report our five-year experience with five patients who developed foot gangrene due to calciphylaxis. All five patients had characteristic clinical, laboratory, and radiologic findings of the disorder, but no diagnostic variable was uniformly present. All five had progressed to advanced gangrene at the time of surgical consultation. Despite aggressive local attempts to control infection, all five patients died of septic complications. Parathyroidectomy was performed in three patients but did not alter the course in any case. This small experience suggests that the outcome of foot gangrene associated with calciphylaxis is predicated on the degree of tissue loss. Aggressive local wound care does not appear to be adequate to control infection in patients who have already developed gangrene. Although parathyroidectomy may have important long-term advantages in patients with calciphylaxis, it does not appear to affect outcome in these advanced cases.

References

Jan 1, 1981·American Journal of Nephrology·H J AdroguéW N Suki

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Citations

Sep 30, 2003·BMC Nephrology·Rainer U PliquettHarald Achenbach
Oct 26, 2005·Annales de chirurgie plastique et esthétique·O TrostA Danino
Aug 29, 2007·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·Sean DineenFrank R Arko

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