Nigwekar Sagar U, Kroshinsky Daniela, Nazarian Rosalynn M, Goverman Jeremy, Malhotra Rajeev, Jackson Vicki Ann, Kamdar Mihir M, Steele David J R, Thadhani Ravi I
Division of Nephrology, Massachusetts General Hospital, Boston, MA.
Department of Dermatology, Massachusetts General Hospital, Boston, MA.
Am J Kidney Dis. 2015 Jul;66(1):133-46. doi: 10.1053/j.ajkd.2015.01.034. Epub 2015 May 7.
Calciphylaxis is a rare but devastating condition that has continued to challenge the medical community since its early descriptions in the scientific literature many decades ago. It is predominantly seen in patients with chronic kidney failure treated with dialysis (uremic calciphylaxis) but is also described in patients with earlier stages of chronic kidney disease and with normal kidney function. In this review, we discuss the available medical literature regarding risk factors, diagnosis, and treatment of both uremic and nonuremic calciphylaxis. High-quality evidence for the evaluation and management of calciphylaxis is lacking at this time due to its rare incidence and poorly understood pathogenesis and the relative paucity of collaborative research efforts. We hereby provide a summary of recommendations developed by a multidisciplinary team for patients with calciphylaxis.
钙过敏症是一种罕见但极具破坏性的病症,自几十年前在科学文献中首次被描述以来,一直困扰着医学界。它主要见于接受透析治疗的慢性肾衰竭患者(尿毒症性钙过敏症),但也见于慢性肾脏病早期阶段以及肾功能正常的患者。在本综述中,我们讨论了关于尿毒症性和非尿毒症性钙过敏症的危险因素、诊断和治疗的现有医学文献。由于其发病率低、发病机制尚不清楚以及协作研究相对较少,目前缺乏评估和管理钙过敏症的高质量证据。我们在此提供一个多学科团队为钙过敏症患者制定的建议总结。