Abstract: SA-PO0337
Calciphylaxis After Recovery from AKI: An Unusual Case Report
Session Information
- AKI: Case Reports - Drug/Toxin Injury, Crystals, Obstruction, and Unusual Presentations
October 24, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Acute Kidney Injury
- 102 AKI: Clinical, Outcomes, and Trials
Authors
- Marnet, Erica, Yale School of Medicine, New Haven, Connecticut, United States
- Golestaneh, Ladan, Yale School of Medicine, New Haven, Connecticut, United States
Introduction
Calciphylaxis is a rare life-threatening vasculopathy resulting from deposition of calcium in the medial layer of arteriolar microvasculature in deep dermis and subcutaneous adipose tissue. Though mostly seen in individuals with kidney failure, it can rarely present in patients without any kidney disease or with mild to moderate acute kidney injury (AKI).
Case Description
A 64-year-old female with obesity presented to the emergency department with a 1-week history of painful blisters of her bilateral lateral thighs. Initially the lesions presented as small vesicles, which then progressed to bigger blisters followed by a black eschar with induration. Two months prior to this presentation, she was admitted with alcohol-associated hepatitis, and AKI in the context of chronic alcohol use. Blood chemistry at that time was significant for a creatinine of 7.8 mg/dL, bilirubin of 30 mg/dL, corrected calcium of 9.8 mg/dL, phosphorus 4.0 mg/dL. She required 8 hemodialysis sessions and was treated with a 4-week steroid course given elevated Maddrey’s scores but recovered renal function. During the current admission her creatinine was 1.01, bilirubin 4.1, corrected calcium 10, phosphorus 2.9, PTH 20 pg/mL, vitamin D25 61 ng/mL. Skin punch biopsy showed calcification of small vessels consistent with calciphylaxis. Further testing revealed deficiency in protein C activity. She received vitamin K repletion and started on sodium thiosulfate three times a week with no significant improvement in her lesions.
Discussion
In addition to kidney failure, major risks factors for calciphylaxis are female sex, corticosteroids, obesity, alcoholic liver disease, vitamin K, protein C or S deficiencies and warfarin use. Timely diagnosis of calciphylaxis in AKI population requires a high level of suspicion and prompt skin biopsy for adequate treatment.
Lateral thigh lesion