The role of iron in calciphylaxis—a current review

Wickens, O., Rengarajan, S., Chinnadurai, R., Ford, I. , Macdougall, I. C., Kalra, P. A. and Sinha, S. (2022) The role of iron in calciphylaxis—a current review. Journal of Clinical Medicine, 11(19), 5779. (doi: 10.3390/jcm11195779) (PMID:36233647) (PMCID:PMC9570530)

Abstract

Calcific uraemic arteriolopathy (CUA), also known as calciphylaxis, is a rare and often fatal condition, frequently diagnosed in end-stage renal disease (ESRD) patients. Although exact pathogenesis remains unclear, iron supplementation is suggested as a potential risk factor. Iron and erythropoietin are the main stay of treatment for anaemia in ESRD patients. Few observational studies support the role of iron in the pathogenesis of calciphylaxis although data from the pivotal trial was not strongly supportive of this argument, i.e., no difference in incidence of calciphylaxis between the low-dose and high-dose iron treatment arms. Elevated levels of vascular cell adhesion molecules in association with iron excess were postulated to the pathogenesis of CUA by causing inflammation and calcification within the microvasculature. In-addition, oxidative stress generated because of iron deposition in cases of systemic inflammation, such as those seen in ESRD, may play a role in vascular calcification. Despite these arguments, a direct correlation between cumulative iron exposure with CUA incidence is not clearly demonstrated in the literature. Consequently, we do not have evidence to recommend iron reduction or cessation in ESRD patients that develop CUA.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Ford, Professor Ian

Creator Roles

Ford, I.: Writing – review and editing

• Authors: Wickens, O., Rengarajan, S., Chinnadurai, R., Ford, I., Macdougall, I. C., Kalra, P. A., and Sinha, S.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Robertson Centre
• Journal Name: Journal of Clinical Medicine
• Publisher: MDPI
• ISSN: 2077-0383
• ISSN (Online): 2077-0383
• Published Online: 29 September 2022
• Copyright Holders: Copyright © 2022 The Authors
• First Published: First published in Journal of Clinical Medicine 11(19): 5779
• Publisher Policy: Reproduced under a Creative Commons License