Calciphylaxis

Treatment

Calciphylaxis is first treated with conservative therapy such as changing diet, medications and the dialysis prescription (for patients already on dialysis). Doctors evaluate and eliminate potential trigger factors such as corticosteroids or use of iron and calcium supplements and work to bring calcium and phosphate to normal levels. This may involve using a medication (Cinacalcet) or surgery to better regulate PTH hormone, a hormone secreted by the parathyroid glands which regulates the body's use of calcium and phosphorus. Doctors often refer patients to a dietitian familiar with the dietary needs and restrictions of patients with kidney disease.

A new treatment, tissue plasminogen activator (tPA, alteplase), has shown promise in preventing major ulceration and reducing patient mortality. This medication (also used in treating heart attacks) can dissolve blood clots in skin blood vessels affected by calciphylaxis.

Other treatments include:

• Low-calcium bath dialysis
• Medical or surgical treatment to reduce the concentration of parathyroid hormone
• Antibiotic treatment
• Pain medication
• Intravenous vitamin D (in special circumstances)
• Hyperbaric oxygen treatments
• Blood thinning medications

Surgery

For patients with clearcut evidence of overactive parathyroid glands, surgery to remove all or part of the parathyroid glands may be necessary — although this does not guarantee that hyperparathyroidism won't recur. Surgery may also be needed to remove dead or contaminated tissue to avoid infection or amputation.