Table 2.
Meta-analysis of clinical characteristics and outcomes of patients with calciphylaxis according to treatment modality (derived from case series)
| Variables | Sodium thiosulfate |
Surgical Parathyroidectomy |
Cinacalcet |
Hyperbaric oxygen therapy |
Bisphosphonates |
||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| No. of studies | No. of patients | Weighted mean (95% CI) | No. of studies | No. of patients | Weighted mean (95% CI) | No. of studies | No. of patients | Weighted mean (95% CI) | No. of studies | No. of patients | Weighted mean (95% CI) | No. of studies | No. of patients | Weighted mean (95% CI) | |
| Clinical characteristics | |||||||||||||||
| Age, yr | 14 | 321 | 58.5 (44.0–73.0) | 11 | 54 | 53.3 (48.1–58.4) | 3 | 12 | 53.3 (36.3–70.2) | 5 | 61 | 57.7 (54.0–61.4) | 1 | 3 | 58.5 (44.0–73.0) |
| Dialysis vintage, yr | 8 | 228 | 2.9 (2.1–3.7) | 7 | 33 | 7.3 (5.1–9.4) | 2 | 10 | 3.5 (1.6–5.5) | 3 | 18 | 8.4 (1.5–18.3) | – | – | – |
| Serum calcium, mg/dl | 9 | 303 | 9.2 (8.8–9.7) | 10 | 51 | 9.5 (9.0,10.0) | 3 | 12 | 8.8 (6.5,11.1) | 5 | 61 | 9.4 (8.7–10.0) | 1 | 3 | 9.0 (7.9–10.3) |
| Serum phosphorus, mg/dl | 9 | 303 | 5.7 (5.4–6.1) | 10 | 51 | 5.7 (5.4–6.1) | 3 | 12 | 5.3 (4.7–5.9) | 5 | 61 | 6.6 (5.4–7.8) | 1 | 3 | 6.3 (3.9–8.7) |
| Serum albumin, g/dl | 4 | 269 | 3.0 (2.6–3.5) | 2 | 12 | 3.4 (2.9–3.9) | 1 | 2 | 3.5 (3.5–3.5) | 2 | 14 | 2.8 (2.2–3.3) | 1 | 3 | 3.1 (2.2–4.0) |
| Serum intact parathyroid hormone, pg/ml | 10 | 305 | 431.3 (329.0–533.5) | 8 | 38 | 640.1 (393.3–886.8) | 3 | 12 | 999.6 (683.4–1315.7) | 4 | 50 | 202.4 (55.1–349.8) | 1 | 3 | 459.0 (97.7–1015.7) |
| Clinical outcomes | |||||||||||||||
| Amputation, % | 12 | 85 | 11.9 (6.5–20.9) | 10 | 44 | 41.1(24.3–60.2) | 3 | 12 | 10.4 (2.1–38.8) | 4 | 52 | 9.3 (3.0–25.6) | – | – | – |
| Worsening of lesions, % | 14 | 321 | 30.4 (24.3–37.3) | 11 | 54 | 43.7 (24.4–65.1) | 3 | 12 | 30.4 (4.9–78.9) | 4 | 52 | 37.3 (25.3–51.2) | 1 | 3 | 66.7 (15.4–95.7) |
| Mortality, % | 14 | 321 | 44.4 (31.1–58.6) | 10 | 44 | 44.9 (29.2–61.7) | 3 | 12 | 62.8(8.2–97.0) | 4 | 52 | 43.8 (11.3–82.6) | – | – | – |