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Abstract: PO0562

Regional Epidemiological Investigation of Calciphylaxis in Chinese Hemodialysis Patients

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
  • 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 (calcific uremic arteriolopathy, CUA) is a grievous life-threatening vascular disease that commonly affects dialysis patients. This is the first epidemiological survey of CUA initiated in China.

Methods

In the cross-sectional survey during Oct. 2018 to Oct. 2019, a stratified sampling method was used to select 24 dialysis centers in Jiangsu Province in China. The participants were all adult patients in each center, who had been on hemodialysis for more than 6 months. This multicenter investigation was conducted in the form of questionnaires, which were filled in by doctors or nurses according to the actual situation of patients. CUA patients were uniformly diagnosed by the Calciphylaxis Study Group based on characteristic skin lesions and histopathological features.

Results

A total of 3867 hemodialysis patients (average age of 55.33±13.89 years; 61.81% of males) were included. 48 cases were diagnosed with CUA, and the prevalence was 1.24%. Among CUA patients, 68.75% of cases were male, and average age and median dialysis duration were 53.85±15.17 years and 84.00(48.00, 138.75) months respectively. The average BMI of CUA patients was higher than that of controls, and patients with hyperparathyroidism, diabetes, atrial fibrillation, stroke, or tumors were more likely to suffer from the disease. Although only 4 CUA patients used warfarin therapy, there was still a significant statistical difference between two groups. Multivariate analysis indicated that increased BMI, prolonged dialysis duration, warfarin therapy, concomitant with hyperparathyroidism, diabetes mellitus or tumors, low ALB, and high serum ALP levels were high-risk factors for CUA. 394 (10.32%) of 3819 hemodialysis patients who didn't meet current diagnostic criteria for CUA had a variety of manifestations of skin lesions, mainly in lower limbs. 28.68% of these patients complained about a progressive deterioration of skin damage, and 44.67% suffered moderate to severe pain with potential CUA risks.

Conclusion

The prevalence of CUA in Chinese hemodialysis patients was 1.24% according to this regional epidemiological survey, but its actual prevalence would be presumably far beyond present data. Calciphylaxis, as a disease with such a high disability and fatality rate, should attract the attention of relevant specialists.