Revisiting therapeutic options for calciphylaxis

Curr Opin Nephrol Hypertens. 2019 Sep;28(5):448-454. doi: 10.1097/MNH.0000000000000520.


Purpose of review: Calciphylaxis is a disorder of cutaneous microvascular calcification and thrombosis leading to chronic, excruciatingly painful, progressive wounds with a high risk of sepsis and death. The diagnosis and treatment of calciphylaxis presents significant challenges. A poorly understood disease, the management of calciphylaxis has mostly been restricted to wound management and a few novel therapies. Data from patient registries and new studies on causal pathways is stimulating the development of pathogenesis-based medical therapies.

Recent findings: Much needed clinical trials are now underway to examine the safety and efficacy of sodium thiosulfate and other therapeutics for the indication of calciphylaxis. There is emerging data suggesting a potential role of therapeutic anticoagulation in these patients. There has also been a renewed emphasis on patient-oriented outcomes, such as improvement of pain scores and quality-of-life indices.

Summary: This review highlights ongoing clinical trials studying therapeutic options in calciphylaxis and emphasizes the causal pathways that led to the development of such therapies.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Anticoagulants / therapeutic use
  • Calciphylaxis / diagnosis
  • Calciphylaxis / etiology
  • Calciphylaxis / therapy*
  • Cinacalcet / therapeutic use
  • Clinical Trials as Topic
  • Humans
  • Pain Management
  • Parathyroidectomy
  • Thiosulfates / therapeutic use


  • Anticoagulants
  • Thiosulfates
  • sodium thiosulfate
  • Cinacalcet