ESKD, Calciphylaxis Subtypes, and Patient Demographics

Background: Calciphylaxis is a rare life-threatening vascular calcification disease associated with morbidity and mortality. Calciphylaxis presents heterogeneous outcomes and poses challenges in management due to limited treatment options and poor prognosis. This study aims to assess the associations between End Stage Kidney Disease (ESKD), different calciphylaxis subtypes and demographics. Methods: This is a prospective cohort study of calciphylaxis patients within the Partners Calciphylaxis Biorepository and Patient Registry between 2017 and 2023. We examined the associations between ESKD status, lesion location, clinical and histopathological characteristics. Results: Among 166 adult patients with calciphylaxis, 112 had ESKD while 54 did not. Compared to non-ESKD calciphylaxis patients, ESKD patients were more likely to be Black (OR:5.20, 95% CI: 1.58,21.40, P =0.011), hypertensive (49% vs 28%, P=0.015), coronary artery disease (46 vs 28%, P=0.043), peripheral vascular disease (48%vs 24%, P=0.005). Upon diagnosis, 104 patients exhibited at least one lesion proximal to the elbows and knees and were classified as having central calciphylaxis distribution while 62 patients had lesions solely distal to the elbows and knees and were classified as having peripheral calciphylaxis distribution. Patients with peripheral lesions were more likely to be older (67 years [55, 73] vs (59 [49, 68], P=0.008), males (44% vs 27%, P=0.042), with indurations (77% vs 47% P<0.001), plaques (63% vs 40% P=0.009), and nodules (42% vs 13% P<0.001) and less likely to have a history of congestive heart failure (31% vs 51% P=0.017) compared to those with central lesions. Conclusion: Our study identified associations between ESKD status and calciphylaxis lesion location with patient demographics and cutaneous lesion characteristics. Funding: NIDDK Support