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Non-Uraemic Calciphylaxis Risk Factors — ESENeph MCQ

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HardHaemodialysisNon-Uraemic Calciphylaxis Risk FactorsESENeph

A 60-year-old man with CKD G5D develops calcific uraemic arteriolopathy (calciphylaxis) affecting his abdominal pannus. He has diabetes, is obese (BMI 38), and is on Warfarin. What patient factors are associated with non-uraemic calciphylaxis?

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Correct answer: C — Non-uraemic calciphylaxis can occur with Warfarin use, obesity, liver disease, hypercoagulable states, and primary hyperparathyroidism even without CKD; Warfarin inhibits matrix Gla protein activation promoting vascular calcification

While calciphylaxis is most commonly associated with dialysis patients, it can occur in non-uraemic contexts. Key non-uraemic risk factors include: Warfarin use (inhibits vitamin K-dependent matrix Gla protein, a calcification inhibitor), obesity, liver disease (reduced protein C/S), hypercoagulable states, primary hyperparathyroidism, and corticosteroid use. Warfarin is increasingly recognised as an independent risk factor for both uraemic and non-uraemic calciphylaxis. Management principles are similar regardless of uraemic status: stop Warfarin, wound care, sodium thiosulphate (if tolerated), and treat underlying risk factors.

Reference: UKKA 2019 – Calciphylaxis; Nigwekar et al 2018 – Non-Uraemic Calciphylaxis