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Palliative care use and patterns of end-of-life care in hospitalized patients with calciphylaxis

Journal of Pain and Symptom Management February 1, 2019

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Research Areas


Calciphylaxis is a rare, debilitating condition characterized by extremely painful ischemic skin lesions and is associated with a one-year mortality of 25%–80% at the time of diagnosis. End-stage renal disease (ESRD) patients with calciphylaxis have a worse prognosis than non-ESRD patients with the same condition. In addition, nearly 50% of patients with calciphylaxis suffer from limited mobility due to severe pain, and more than 70% are hospitalized for severe skin ulcers. Furthermore, calciphylaxis does not have any approved treatments although agents such as sodium thiosulfate have been reported to ameliorate skin lesions with varying efficacy.

Despite the high rates of morbidity and mortality associated with calciphylaxis, and the lack of effective treatments, understanding of palliative care (PC) use and end-of-life (EOL) care in calciphylaxis patients is limited. PC has been associated with improved EOL care in patients with incurable diseases—especially for patients with ESRD on dialysis who comprise the majority of calciphylaxis patients. In this study, we sought to describe the frequency of PC consultations and patterns of EOL care among hospitalized patients with calciphylaxis before death.


National Institute of Diabetes and Digestive and Kidney Diseasesd