Therapy for calciphylaxis: An outcome analysis

Violaceous skin lesions that progress to nonhealing ulcerations and gangrene characterize calciphylaxis. These lesions, which are associated with secondary hyperparathyroidism, are resistant to medical therapy and may lead to amputation, uncontrollable sepsis, and death. In this retrospective analysis, patient, disease, and treatment variables were obtained from the patients' medical records. Paired t-tests, chi-square analysis, and two-tailed Fisher's exact tests compared variables. Survival curves were generated using the Kaplan-Meier method; the log-rank test determined survival differences. From 1993 to 2001, 35 patients were treated; 26 (74%) were female and 20 (57%) were African-American. The cause of the renal failure was hypertension in 37% and diabetes mellitus in 26%. Twenty-three patients (66%) underwent a parathyroid resection involving 4 glands and autotransplantation in 12, 3 1 2 glands in 7, and