Hyperbaric oxygen treatment in addition to conventional multidisciplinary care in patients with calciphylaxis.

IF 1.1 4区医学 Q3 UROLOGY & NEPHROLOGY

Clinical nephrology Pub Date : 2024-11-20 DOI:10.5414/CN111423

Fredrik Barth Brekke, Nanna von der Lippe, Ine Røed, Helga Gudmundsdottir, Martin Braaten, Espen Nordheim

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Abstract

Background: Calciphylaxis is a rare and serious complication in patients with kidney disease. It has few treatment options and poor prognosis. Hyperbaric oxygen therapy (HBOT) may improve wound healing and was added to our conventional care in 2012.

Materials and methods: Data from all calciphylaxis patients treated from 2012 to 2022 were retrieved from hospital records. HBOT was added to our multidisciplinary care of calciphylaxis, which included sodium-thiosulphate, dialysis if indicated, medical optimization of calcium-phosphate homeostasis, substitution of vitamin K2, withdrawal of warfarin, iron and vitamin D, and minimization of systemic steroids. In addition, weight- and nutritional status was optimized, and wound care was thoroughly performed.

Results: 25 patients received a total number of 1,493 HBOT treatments in addition to conventional care in the study period. Median HBOT per patient was 45 (range 1 - 267). One year after diagnosis, 18 out of 25 patients were alive. 15 out of the 18 patients alive 1 year after diagnosis had completely resolved wound lesions. Seven patients died within the first year after diagnosis due to cardiovascular disease (n = 3), infection (n = 3), and cancer (n = 1).

Conclusion: Our results suggest that HBOT is well-tolerated and may be associated with beneficial effects on survival and wound-healing when combined with multidisciplinary care.

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在对钙血症患者进行常规多学科治疗的同时进行高压氧治疗。

背景：血钙症是肾病患者一种罕见的严重并发症。治疗方法少，预后差。高压氧疗法（HBOT）可改善伤口愈合，并于2012年被添加到我们的常规治疗中：从医院记录中检索了2012年至2022年接受治疗的所有钙化性紫癜患者的数据。HBOT 被添加到我们的钙磷血症多学科治疗中，其中包括硫代硫酸钠、透析（如有指征）、优化钙磷平衡的药物、维生素 K2 替代品、停用华法林、铁剂和维生素 D，以及尽量减少全身类固醇。此外，还对体重和营养状况进行了优化，并对伤口进行了全面护理。结果：在研究期间，25 名患者除接受常规治疗外，还接受了共计 1,493 次 HBOT 治疗。每位患者接受 HBOT 治疗的中位数为 45 次（1 - 267 次不等）。确诊一年后，25 名患者中有 18 人存活。在确诊一年后存活的 18 名患者中，有 15 名患者的伤口病变已完全消退。7 名患者在确诊后一年内因心血管疾病（3 人）、感染（3 人）和癌症（1 人）死亡：我们的研究结果表明，HBOT具有良好的耐受性，如果与多学科治疗相结合，可能会对患者的生存和伤口愈合产生有益的影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical nephrology 医学-泌尿学与肾脏学

CiteScore

2.10

自引率

9.10%

发文量

138

审稿时长

4-8 weeks

期刊介绍： Clinical Nephrology appears monthly and publishes manuscripts containing original material with emphasis on the following topics: prophylaxis, pathophysiology, immunology, diagnosis, therapy, experimental approaches and dialysis and transplantation.