Calciphylaxis, also known as calcific uremic arteriolopathy (CUA), is a rare cutaneous vascular disease characterized by painful and progressive ischemic skin lesions, classically occurring in chronic kidney disease (CKD) patients. The pathohistological features include calcification, microthrombosis, and fibrointimal hyperplasia of dermal and subcutaneous arteries and arterioles. Sepsis is the most common cause of death, with 1-year mortality up to 80%. It has been hypothesized that calciphylaxis in normal-renal function and CKD patients shared similar pathogenesis, however, little evidence is available to support that. Clinical or epidemiological studies on the comparisons between normal-renal function populations and CKD calciphylaxis patients are beneficial for the field. The lack of populational/clinical studies in calciphylaxis patients and animal models research restricts further development of both clinical practice and basic sciences. Moreover, there are limited guidelines available for this condition to standardize treatment approaches.
CKD-mineral and bone disorder (CKD-MBD) is characterized by dysregulated mineral and bone metabolism, bone abnormalities, and vascular calcification. CKD-MBD can be seen in non-dialysis, dialysis, and kidney transplant patients. Skin and bone biopsies are the gold standards for the diagnosis of calciphylaxis and renal osteodystrophy (ROD), but they are invasive. It is promising to deepen the basic research to facilitate bench-to-bedside translation. The new biomarkers, non-invasive imaging techniques for microvascular injury, and ROD will improve the diagnosis ability for calciphylaxis and CKD-MBD patients. The safety and efficacy of novel treatment strategies are in further need of exploration. For patients with long-term and critical illnesses, physical and spiritual care from medical teams and their families will shed light on their rehabilitation.
Any article types consistent with Renal Failure's author guidelines that investigate the following aspects are welcomed:
- The comparisons of epidemiology, clinical features, and laboratory abnormalities between normal-renal function and CKD calciphylaxis populations. Critical and challenging CKD-MBD situations can be discussed in the case series.
- Suitable mechanistic research and animal model developments.
- Histological, imaging, and genetic background analysis on the subject.
- Opportunities for incremental improvement of conventional multidisciplinary treatments.
- Novel treatments, including microbiota manipulation, stem cell therapy, RNA therapy, monoclonal antibody therapy, nursing & supportive treatments, and care perspective of family members or caregivers.
