Evidence map›Paper›PMID 41367922›Full record

ReviewClinical kidney journal2025

Calciphylaxis diagnosis, management and future directions: a comprehensive update on behalf of the European Renal Association CKD-MBD Working Group.

Sharon Huish, Sacha Moore, Carlo Alfieri, Antonio Bellasi, Daniel Cejka, Martin H de Borst, Juan Miguel Diaz-Tocados, Pietro Manuel Ferraro, Maria Fusaro, Mathias Haarhaus and 4 more

Abstract readReview
In one paragraph

Review in Clinical kidney journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Sharon HuishDepartment of Renal Dietetics, Royal Devon University Healthcare NHS Foundation Trust, and University of Exeter, Exeter, UK.ORCID https://orcid.org/0000-0003-3161-1552
Sacha MooreWales Kidney Research Unit, Cardiff University, Cardiff, UK.
Carlo AlfieriUnit of Nephrology, Dialysis and Kidney Transplantation, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy.
Antonio BellasiService of Nephrology, Ospedale Regionale di Lugano, Ospedale Civico, Ente Ospedaliero Cantonale, Lugano, Switzerland.
Daniel CejkaDepartment of Medicine III - Nephrology, Transplantation Medicine, Rheumatology, Geriatrics, Ordensklinikum Linz Elisabethinen Hospital, Linz, Austria.
Martin H de BorstDepartment of Internal Medicine, Division of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Juan Miguel Diaz-TocadosVascular and Renal Translational Research Group, Biomedical Research Institute of Lleida-Dr Pifarré Foundation (IRBLleida), Lleida, Spain.
Pietro Manuel FerraroSection of Nephrology, Department of Medicine, Università degli Studi di Verona; Nephrology Unit, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy.ORCID https://orcid.org/0000-0002-1379-022X
Maria FusaroNational Research Council (CNR), Institute of Clinical Physiology (IFC), Pisa, Italy.ORCID https://orcid.org/0000-0001-9478-4851
Mathias HaarhausDivision of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.ORCID https://orcid.org/0000-0001-8274-6356
Ditte HansenDepartment of Nephrology, Copenhagen University Hospital - Herlev, Copenhagen, Denmark.ORCID https://orcid.org/0000-0003-4929-7901
Mehmet KanbayDepartment of Medicine, Division of Nephrology, Koc University School of Medicine, Istanbul, Turkey.ORCID https://orcid.org/0000-0002-1297-0675
Markus KettelerInternal and Geriatric Medicine, Robert-Bosch-Krankenhaus, Stuttgart, Germany.
Smeeta SinhaDonal O'Donoghue Renal Research Centre, Northern Care Alliance NHS Foundation Trust, Salford,  UK.ORCID https://orcid.org/0000-0003-4117-4085

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Calciphylaxis, or calcific uraemic arteriolopathy, is a rare and life-threatening condition predominantly affecting people receiving dialysis. Characterized by painful necrotic skin lesions due to arteriolar calcification and thrombosis, calciphylaxis is associated with high morbidity and mortality. Diagnosis is frequently delayed due to misdiagnosis and an absence of specific diagnostic tests. Current treatment approaches are largely based on registry data and small uncontrolled studies. This update brings together the latest understanding of calciphylaxis pathogenesis, diagnostic approaches and management, highlighting recent advances and future directions. Pathophysiological mechanisms include vascular smooth muscle cell osteogenic transformation, loss of endogenous calcification inhibitors (fetuin-A, matrix Gla protein, pyrophosphate), systemic inflammation and thrombosis. The potential prognostic role of biomarkers, including the calciprotein particle crystallization test (T50) and plasma pyrophosphate, are also discussed. Management remains complex, with no proven treatments. A multifaceted, and multi-professional team approach is fundamental. Sodium thiosulfate remains widely used despite the lack of trial evidence. Recent investigational therapies, including SNF472 and INZ-701, target key calcification pathways and offer promise. The Better Evidence and Translation for Calciphylaxis (BEAT-Calci) adaptive platform trial represents a landmark step in evaluating multiple therapies systematically. National registries remain vital for informing prevalence estimates and improving real-world outcome data. Looking ahead, future research should prioritize the development and validation of diagnostic criteria, and prognostic tools integrating clinical risk factors with biomarkers. In addition, we propose the routine inclusion of patient-reported experience measures in calciphylaxis studies to better capture treatment impact in this vulnerable population.

Indexed as

calcific uraemic arteriolopathycalciphylaxisCKDkidney failure

Identifiers

PMID41367922
PMCPMC12683247

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.