genitourinary disorders
Medical Aspects of Long Term Renal Replacement Therapy
Calciphylaxis
Calciphylaxis is a rare disorder of systemic arterial calcification causing ischemia and necrosis in localized areas of the fat and skin of the trunk, buttocks, and lower extremities. Cause is unknown, though hyperparathyroidism,vitamin Dsupplementation, and elevated calcium (Ca) and phosphate (PO4) levels are thought to contribute. It manifests as painful, violaceous, purpuric plaques and nodules that ulcerate, form eschars, and become infected. It is often fatal. Treatment is usually supportive. Several cases have been reported in whichsodium thiosulfategiven IV at the end of dialysis 3 times a week along with aggressive efforts to reduce the serum Ca×PO4 product has resulted in considerable improvement. 