An J, Devaney B, Ooi KY, Ford S, Frawley G, Menahem S, et al.
Nephrology (Carlton, Vic.). Date of publication 2015 Jul 1;volume 20(7):444-50.
1. Nephrology (Carlton). 2015 Jul;20(7):444-50. doi: 10.1111/nep.12433.
Hyperbaric oxygen in the treatment of calciphylaxis: A case series and
literature review.
An J(1), Devaney B(2), Ooi KY(1), Ford S(1), Frawley G(2), Menahem S(1).
Author information:
(1)Department Renal Medicine, Alfred Hospital, Melbourne, Victoria, Australia.
(2)Department Intensive Care and Hyperbaric Medicine, Alfred Hospital,
Melbourne, Victoria, Australia.
AIMS: Calcific uraemic arteriolopathy (CUA) or calciphylaxis is most commonly
seen in end-stage renal disease and is associated with significant morbidity and
mortality. The aim of this study was to determine whether hyperbaric oxygen
therapy (HBOT) is effective in healing calciphylaxis lesions and to determine if
there are any patient factors that can predict wound healing and patient
survival.
METHODS: We identified by retrospective review all cases of CUA referred to our
institution for treatment with HBOT. We documented the clinical and biochemical
parameters of this patient population, the size and distribution of the lesions
as well as wound outcomes and patient survival following treatment.
RESULTS: A total 46 patients were identified with CUA associated with renal
failure. Of the 46 patients, only 34 received a full course of HBOT. The balance
was deemed unsuitable for treatment or was unable to tolerate treatment and was
palliated. Of the 34 patients that received a full course of HBOT, 58% showed
improvement in their wound scores, with more than half of these patients having
complete healing of their wounds. The balance did not benefit from the therapy
and had a very poor prognosis. Those that benefited from HBOT survived on
average for more than 3 years. The only factor significantly associated with
improved wound healing and survival was diabetes.
CONCLUSION: This retrospective analysis suggests a role for HBOT in the
treatment of CUA with more than half of the treated patients benefiting and
surviving for an average of more than 3 years.
© 2015 Asian Pacific Society of Nephrology.
DOI: 10.1111/nep.12433
PMID: 25707425 [Indexed for MEDLINE]
