Certified Wound Ostomy Nurse (CWON) Practice Test

Which condition is majorly associated with an increased risk of calciphylaxis?

1. Diabetes Mellitus

2. End-stage renal disease (usually with dialysis)

3. Chronic obesity

4. Liver cirrhosis

The correct answer is: End-stage renal disease (usually with dialysis)

The condition most strongly associated with an increased risk of calciphylaxis is end-stage renal disease, particularly in patients undergoing dialysis. Calciphylaxis is a rare but serious condition characterized by calcification of blood vessels, leading to ischemic skin necrosis. This phenomenon is frequently observed in patients with impaired kidney function, particularly those with end-stage renal disease. In such patients, the derangement in calcium and phosphate metabolism leads to hyperphosphatemia and secondary hyperparathyroidism. Over time, these conditions contribute to vascular calcification and increase the risk of calciphylaxis. Patients with end-stage renal disease often have elevated phosphate levels due to reduced excretion by the kidneys, leading to complexes with calcium that precipitate in vascular structures. Therefore, the significant risk factors in patients with end-stage renal disease, especially those receiving dialysis, include altered mineral metabolism and the presence of comorbidities like diabetes and obesity, which can further intensify the vascular susceptibility. This relationship underscores the importance of monitoring and managing the calcium-phosphate balance in these patients to mitigate the risks associated with calciphylaxis.