Gallo Marin Benjamin, Aghagoli Ghazal, Hu Susie L, Massoud Cathy M, Robinson-Bostom Leslie
Department of Dermatology, Warren Alpert Medical School of Brown University, Providence, Rhode Island.
Division of Kidney Disease and Hypertension, Department of Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island.
Am J Kidney Dis. 2023 Feb;81(2):232-239. doi: 10.1053/j.ajkd.2022.06.011. Epub 2022 Aug 12.
Calciphylaxis is a life-threatening complication most often associated with chronic kidney disease that occurs as a result of the deposition of calcium in dermal and adipose microvasculature. However, this condition may also be seen in patients with acute kidney injury. The high morbidity and mortality rates associated with calciphylaxis highlight the importance to correctly diagnose and treat this condition. However, calciphylaxis remains a diagnosis that may be clinically challenging to make. Here, we review the literature on uremic calciphylaxis with a focus on its pathophysiology, clinical presentation, advances in diagnostic tools, and treatment strategies. We also discuss the unique histopathological features of calciphylaxis and contrast it with those of other forms of general vessel calcification. This review emphasizes the need for multidisciplinary collaboration including nephrology, dermatology, and palliative care to ultimately provide the best possible care to patients with calciphylaxis.
钙化防御是一种危及生命的并发症，最常与慢性肾脏病相关，它是由于钙在真皮和脂肪微血管中沉积而发生的。然而，这种情况也可见于急性肾损伤患者。钙化防御相关的高发病率和死亡率凸显了正确诊断和治疗这种疾病的重要性。然而，钙化防御仍然是一种临床诊断可能具有挑战性的疾病。在此，我们回顾了关于尿毒症性钙化防御的文献，重点关注其病理生理学、临床表现、诊断工具的进展以及治疗策略。我们还讨论了钙化防御独特的组织病理学特征，并将其与其他形式的一般血管钙化的特征进行对比。本综述强调了多学科协作的必要性，包括肾脏病学、皮肤病学和姑息治疗，以最终为钙化防御患者提供尽可能最佳的治疗。
