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Abstract: SA-PO287

Epidemiological Investigation of Calciphylaxis: Data from China

Session Information

Category: Bone and Mineral Metabolism

  • 402 Bone and Mineral Metabolism: Clinical

Authors

  • Liu, Yuqiu, Institute of Nephrology, Zhong Da Hospital, Southeast University School of Medicine, Nanjing, China
  • Yang, Canlin, Institute of Nephrology, Zhong Da Hospital, Southeast University School of Medicine, Nanjing, China
  • Xie, Xiaotong, Institute of Nephrology, Zhong Da Hospital, Southeast University School of Medicine, Nanjing, China
  • Liu, Bi-Cheng, Institute of Nephrology, Zhong Da Hospital, Southeast University School of Medicine, Nanjing, China
  • Zhang, Xiaoliang, Institute of Nephrology, Zhong Da Hospital, Southeast University School of Medicine, Nanjing, China
Background

Calciphylaxis is a serious life-threatening vascular disease commonly occurred in dialysis patients. Chinese research on calciphylaxis is still in its infancy without epidemiological data. A regional epidemiological study of calciphylaxis was initiated at first time in China to find out its prevalence and clinical characteristics in Chinese hemodialysis patients.

Methods

The project was initiated in Aug. 2018. Stratified sampling method was used to select 28 dialysis centers in four regions of Jiangsu Province in China with an estimated sample size of 6000. Inclusion criteria: a. age≥18 years; b. duration of dialysis≥6 months; c. informed consent. The study used a questionnaire included general information and calciphylaxis-related symptoms.

Results

As of Apr. 30, 2019, 3799 hemodialysis patients had completed questionnaires. 77.0% of patients hadn’t heard of calciphylaxis, and another 9.2% only knew the name. Among them, 27 patients were diagnosed with calciphylaxis and unadjusted prevalence rate in hemodialysis patients was 0.71%. Of the diagnosed patients, 70.4% were male with an average age and duration of dialysis of 55.8±15.3 years and 86.0 (36.0, 144.0) months respectively. 13 patients had diabetes and 19 had secondary hyperparathyroidism [the median iPTH was 561.8 (312.9, 817.8) pg/mL]. Only one used warfarin therapy. Surprisingly, 383 of 3799 (10.1%) had different types of skin lesions, including rough skin (48.3%), sensory sensitivity or loss (15.6%), diffuse rash (14.6%), calcified nodules (6.5%), painful papules (3.7%) and livedo or purpura (15.4%). Lesions were mainly in lower limbs, reaching 56.9%. 116 patients (30.3%) noticed a progressive deterioration of skin damage with potential calciphylaxis risks. Nevertheless, skin biopsy rate of these patients was only 6.3%, which affected further diagnosis.

Conclusion

This is the first epidemiological data about calciphylaxis from China. The preliminary analyses show that prevalence of calciphylaxis in Chinese hemodialysis patients is 0.71%, which seems to be lower than that from other countries due to differences in races and medication habits. In particular, we find some dialysis patients have atypical skin lesions which don’t rule out early manifestations of calciphylaxis. It’s urgent to improve clinical understanding of calciphylaxis, and multifaceted diagnostic methods will be applied for early screening.