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June 1997

Low-Calcium Dialysis in Calciphylaxis

Author Affiliations

Paris; Service de Médecine Interne Hôpital Pitié-Salpétrière 75013 Paris, France; Paris

Arch Dermatol. 1997;133(6):798-799. doi:10.1001/archderm.1997.03890420144029

Calciphylaxis is a potentially life-threatening complication of chronic renal failure.1 Indeed, patients presenting with calciphylaxis may have extensive skin necrosis due to medial calcification and intimal hyperplasia in subcutaneous arteries.2,3 Parathyroidectomy is the treatment of choice, although often unrewarding.2 In radiographs the process is seen as a fine double-lined network of calcifications. However, radiographs taken after recovery from necrosis often fail to demonstrate any regression of small artery calcification.

We describe a patient with chronic renal failure who developed calciphylaxis and in whom low-calcium dialysis led to significant improvement. Readings from a 3-dimensional scanner clearly showed the extent of the calcification and its regression after treatment.

Report of a Case.  A 46-year-old African man was hospitalized for chronic renal failure (creatinine level, 1358 μmol/L [15.36 mg/dL]), which was a complication of reactive systemic amyloidosis. He first underwent dialysis with femoral catheters in his country and then