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Successful treatment of calciphylaxis with vitamin K in a patient on haemodialysis.

ABSTRACT: Calciphylaxis has high mortality. Vitamin K deficiency is common in haemodialysis patients and may be a trigger for calciphylaxis due to its role in activating a tissue inhibitor of calcification, matrix Gla protein. We report a second case of a female haemodialysis patient who developed calciphylaxis twice and was successfully treated with vitamin K supplementation on both occasions. She did not receive sodium thiosulphate or bisphosphonates nor was there a change made to her dialysis time or prescription. This case highlights how supplementation with vitamin K may improve the outcome of this condition.

SUBMITTER: Wajih Z

PROVIDER: S-EPMC8825233 | biostudies-literature | 2022 Feb

REPOSITORIES: biostudies-literature

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Successful treatment of calciphylaxis with vitamin K in a patient on haemodialysis.

Wajih Zainab Z Singer Richard R

Clinical kidney journal 20211020 2

Calciphylaxis has high mortality. Vitamin K deficiency is common in haemodialysis patients and may be a trigger for calciphylaxis due to its role in activating a tissue inhibitor of calcification, matrix Gla protein. We report a second case of a female haemodialysis patient who developed calciphylaxis twice and was successfully treated with vitamin K supplementation on both occasions. She did not receive sodium thiosulphate or bisphosphonates nor was there a change made to her dialysis time or p ...[more]

PMID: 35145651

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Project description:ObjectivesTo examine the relative importance of patient and centre level factors in determining self-reported experience of care in patients with advanced kidney disease treated by maintenance haemodialysis (HD).DesignAnalysis of data from a cross sectional national survey; the UK Renal Registry (UKRR) national Kidney patient-reported experience measure (PREM) survey (2018). Centre-level data were obtained from the UKRR report (2018).SettingNational survey of patients with advanced kidney disease receiving treatment with maintenance HD in UK renal centres in 2018.ParticipantsThe Kidney PREM was distributed to all UK renal centres by the UKRR in May 2018. Each centre invited patients receiving outpatient treatment for kidney disease to complete the PREM. These included patients with chronic kidney disease, those receiving dialysis-both HD and peritoneal dialysis, and those with a functioning kidney transplant. There were no formal inclusion/exclusion criteria.Main outcome measuresThe Kidney PREM has 38 questions in 13 subscales. Responses were captured using a 7-point Likert scale (never 1, always 7). The primary outcome of interest was the mean PREM score calculated across all questions. Multilevel modelling was used to determine the proportion of variation of the mean PREM score across centres due to patient-related and centre-related factors.ResultsThere were records for 8253 HD patients (61% men, 77% white) from 69 renal centres (9-710 patients per centre). There was significant variation in mean PREM score across centres (5.35-6.53). In the multivariable analysis there was some variation in relation to both patient- and centre-level factors but these contributed little to explaining the overall variation. However, multilevel modelling showed that the overwhelming proportion of the explained variance (45%) was explained by variation between centres (40%), only a small proportion of which is identified by measured factors. Only 5% of the variation was related to patient-level factors.ConclusionsCentre rather than patient characteristics determine the experience of care of patients receiving HD. Further work is required to define the characteristics of the treating centre which determine patient experience.

Dataset Information

Successful treatment of calciphylaxis with vitamin K in a patient on haemodialysis.

Publications

Successful treatment of calciphylaxis with vitamin K in a patient on haemodialysis.

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