BACKGROUND: Calciphylaxis is a rare, yet life-threatening disease mainly occurring in dialysis patients. Traditional options of treatment remain unsatisfactory. METHODS: Here we present a novel, combined approach, treating calciphylaxis with IV sodium thiosulfate, cinacalcet and sevelamer. In a case series five hemodialysis patients, have been successfully treated with this regimen. Treatment and survival data were analyzed using descriptive statistics. RESULTS: In all patients, a rapid decrease in pain, improvement of general condition and wound healing within six months occurred. Side effects were low. Drug dosages: IV sodium thiosulfate initial dose 119.4 +/- 84.9 g/m(2)/week, maintenance dose 40.6 +/- 9 g/m(2)/week; cinacalcet: maintenance dose 36 +/- 32.9 mg/d and sevelamer maintenance dose 3320 +/-1671 mg/d. One and two year survivals were 100 % and 80 %, respectively. We also report on long-term application of IV sodium thiosulfate of up to 52 months. Patient survival after diagnosis was 52, 84, 21, 36 and 30 months, respectively. Survival since initiation of hemodialysis was 76, 136, 89, 36 and 35 months, respectively. CONCLUSION: This novel combined approach, a multi-modal treatment of calciphylaxis with persistent hyperparathyroidism, using IV sodium thiosulfate, cinacalcet and sevelamer seems to improve the outcome of this devastating disease.
BACKGROUND:Calciphylaxis is a rare, yet life-threatening disease mainly occurring in dialysis patients. Traditional options of treatment remain unsatisfactory. METHODS: Here we present a novel, combined approach, treating calciphylaxis with IV sodium thiosulfate, cinacalcet and sevelamer. In a case series five hemodialysis patients, have been successfully treated with this regimen. Treatment and survival data were analyzed using descriptive statistics. RESULTS: In all patients, a rapid decrease in pain, improvement of general condition and wound healing within six months occurred. Side effects were low. Drug dosages: IV sodium thiosulfate initial dose 119.4 +/- 84.9 g/m(2)/week, maintenance dose 40.6 +/- 9 g/m(2)/week; cinacalcet: maintenance dose 36 +/- 32.9 mg/d and sevelamer maintenance dose 3320 +/-1671 mg/d. One and two year survivals were 100 % and 80 %, respectively. We also report on long-term application of IV sodium thiosulfate of up to 52 months. Patient survival after diagnosis was 52, 84, 21, 36 and 30 months, respectively. Survival since initiation of hemodialysis was 76, 136, 89, 36 and 35 months, respectively. CONCLUSION: This novel combined approach, a multi-modal treatment of calciphylaxis with persistent hyperparathyroidism, using IV sodium thiosulfate, cinacalcet and sevelamer seems to improve the outcome of this devastating disease.
Authors: Sagar U Nigwekar; Craig A Solid; Elizabeth Ankers; Rajeev Malhotra; William Eggert; Alexander Turchin; Ravi I Thadhani; Charles A Herzog Journal: J Gen Intern Med Date: 2014-08 Impact factor: 5.128
Authors: William R Lloyd; Shailesh Agarwal; Sagar U Nigwekar; Karen Esmonde-White; Shawn Loder; Shawn Fagan; Jeremy Goverman; Bjorn R Olsen; Dolrudee Jumlongras; Michael D Morris; Benjamin Levi Journal: J Biomed Opt Date: 2015-08 Impact factor: 3.170
Authors: Romain Arrestier; Caroline Dudreuilh; Philippe Remy; Ghada Boulahia; Bouteina Bentaarit; Claire Leibler; Amir Adedjouma; Tomek Kofman; Marie Matignon; Dil Sahali; Roger Dufresne; Jean-Francois Deux; Charlotte Colin; Philippe Grimbert; Philippe Lang; Pablo Bartolucci; Bernard Maitre; Jeanne Tran Van Nhieu; Vincent Audard Journal: Medicine (Baltimore) Date: 2016-02 Impact factor: 1.817