Hyperbaric oxygen may improve wound healing in patients with calcific uremic arteriolopathy, also known as calciphylaxis, investigators reported at the European Renal Association’s 2023 congress in Milan, Italy.
At a single center, 25 Norwegian patients with calciphylaxis received hyperbaric oxygen as part of multidisciplinary care during 2012-2022. While in a hyperbaric chamber, patients receive 100% oxygen delivered at above-normal air pressure. Normal air is 21% oxygen. Patients received a median 45 hyperbaric oxygen treatments in addition to conventional care, including sodium thiosulfate, dialysis if needed for calcium-phosphate homeostasis, vitamin K2, withdrawal of warfarin, iron, and vitamin D, limited use of systemic steroids, and weight and nutritional interventions. A recent meta-analysis concluded that intravenous sodium thiosulfate treatment provides no benefit in these patients.
Within 1 year, 7 patients died of cardiovascular disease, infection, or cancer. Of the 18 survivors, 15 (83%) had experienced wound healing.
Calciphylaxis is known to be fatal in up to half of patients, the investigators noted. Treatment options are limited. Hyperbaric oxygen may be a helpful adjuvant therapy.
“Hyperbaric oxygen therapy may improve wound healing by increasing tissue oxygenation,” Espen Nordheim, MD, PhD, of Oslo University Hospital in Norway, and colleagues explained. “Our impression is that [hyperbaric oxygen therapy] is well-tolerated and associated with less wound-associated pain.”
The survival rate in this study was higher than reported in other case series. Future research is needed to determine whether hyperbaric oxygen therapy can prolong life.
According to the FDA, potential risks of the treatment include ear and sinus pain, middle ear injuries (eg, tympanic membrane rupture), temporary vision changes, and, rarely, lung collapse.
Nordheim E, Røed I, Brekke FB, Gudmundsdottir H, Braathen MR, Von der Lippe N. Hyperbaric oxygen treatment in calcific uremic arteriolopathy patients in addition to conventional multidisciplinary care. Presented at: ERA 2023 Congress; 2023 June 15-18; Milan, Italy. Abstract 3816.
Cited from Renal Andurology News