Kidney Week

Abstract: FR-PO0595

A Case Series Highlighting Multifactorial Calciphylaxis and the Potential Role of Bedside Imaging in Early Recognition

Session Information

• CKM: Clinical - Meta-Analyses, Predictive Modeling, Care Delivery, and Safety
  October 23, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Cardiovascular-Kidney-Metabolic Health

• 602 Cardiovascular-Kidney-Metabolic Health: Clinical

Authors

• Adejumo, Cindy Kalenga, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada

Cindy Kalenga Adejumo, MD, PhD

• Bhandol, Harjot, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada

Harjot Bhandol, MD

• Ajaj, Abdulaziz Mohammed, King Faisal Specialist Hospital & Research Center, Jeddah, Saudi Arabia

Abdulaziz Mohammed Ajaj, MD, MBBS

• Farah, Myriam, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada

Myriam Farah, MD

Introduction

Calciphylaxis is a rare and highly morbid vasculopathic disorder characterized by vascular calcification, tissue ischemia, and necrosis. Delayed recognition is common and contributes significantly to morbidity and mortality, particularly through infectious complications and sepsis. Early recognition is critical for timely diagnosis and treatment. Diagnosis is challenging in patients with confounding clinical presentations including chronic lymphedema, recurrent cellulitis, atypical skin findings, and substance use disorders that obscure pain perception and cutaneous findings. We present a case series highlighting both traditional and non-traditional risk factors for calciphylaxis and explore the potential supportive role of point-of-care ultrasound (POCUS) and plain radiography.

Case Description

We describe three patients with calciphylaxis. The first patient presented with classic risk factors including ESKD, diabetes, obesity and a swift diagnosis. In contrast, the other two patients were diagnosed with significant delay due to overlapping features including substance use, chronic lymphedema and recurrent cellulitis. In these patients, the initial clinical picture mimicked severe soft tissue infections thus contributing to diagnostic uncertainty and delayed recognition.

Across cases, imaging modalities including POCUS and plain radiography demonstrated extensive soft tissue and vascular calcifications, supporting clinical suspicion prior to or alongside tissue diagnosis

Discussion

This series highlights the heterogenous clinical spectrum of calciphylaxis and emphasizes the importance of recognizing non-traditional contributors including chronic inflammation, recurrent infection, lymphedema, and substance use. These factors may accelerate tissue injury and obscure diagnosis. As such clinicians should have high clinical suspicion of calciphylaxis especially when classic metabolic risk factors are not predominant.

Additionally, our cases demonstrate the potential utility of readily available imaging modalities as supportive diagnostic adjuncts. While biopsy remains the diagnostic gold standard, POCUS and plain radiography may increase early diagnostic suspicion through visualization of soft tissue calcifications in clinically concerning lesions thus serving as valuable supportive tools in recognizing this rare and life-threatening disease.