CHICAGO—Calciphylaxis is more likely to develop in patients on peritoneal dialysis than hemodialysis, according to the largest study to date examining risk factors for the rare and often fatal condition.
The study, presented at the American Society of Nephrology’s 2016 Kidney Week conference, also identified warfarin use and younger age as risk factors for calciphylaxis, which also is known as calcific uremic arteriolopathy.
Using dialysis patient data from 2007 through 2014 from the U.S. Renal Data System, Rakesh Kilari, MD, of the University of Michigan in Ann Arbor, and colleagues identified 1413 calciphylaxis cases and compared these with 375,658 dialysis patients who did not experience calciphylaxis.
Compared with hemodialysis, peritoneal dialysis was associated with greater than 2-fold higher risk of calciphylaxis, the investigators reported. Warfarin use was associated with a 2.8 times greater risk of calciphylaxis compared with non-use.
In addition, compared with patients aged 81 years or older, patients aged 22–45 and 46–65, and 66–80 years had a 2.7-, 2.1-, and 1.3-fold increased risk of calciphylaxis, respectively. The risk also increased with increasing body mass index. The risk was twice as high among female than male patients. The presence of diabetes mellitus was associated with an approximately 30% increased risk compared with its absence.
Earlier this year, a research team led by Sagar U. Nigwekar, MD, of Harvard Medical School and Massachusetts General Hospital in Boston, published results of what was previously the largest study of calciphylaxis ever conducted. The study, published in the Journal of the American Society of Nephrology (2016;27:3421-3429; published online ahead of print on April 14), included 1,030 HD patients with calciphylaxis who were matched by age, sex, and race to 2060 HD patients without calciphylaxis. As in the study by Dr Kilari and colleagues, warfarin use, diabetes mellitus, and higher BMI were associated with an increased risk of calciphylaxis.
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- Kilari R, Wang M, Schaubel DE, et al. Examining risk factors for calciphylaxis. Poster presented at the 2016 Kidney Week meeting in Chicago, Nov. 15-20. Poster FR-PO403.