Calcium defence is a deadly disease characterized by carcinoma and tissue necrosis, which is traditionally associated with chronic kidney disease (ckd), but the pathological mechanisms and treatment strategies of the non-ureatoxic calcium defence (nuc) are chronically lacking in systematic research. Such patients face an annual mortality rate of up to 45 per cent, and there is no standardized programme for clinical management. Although the sodium sulphate (sts) is used in calcification defenses, its evidence in nuc is limited to case reports。
To fill this gap, the research teams of three university hospitals in spain conducted a 10-year multi-centre retrospective study, which included 33 nuc patients diagnosed with skin work, assessed the efficacy and safety of sds intravenous drugs (25g/s, 3 times a week) and analysed the risk factors associated with the disease and the prognosis. The study, published in farmacia hospitalaria, provides important data support for nut's clinical decision-making。
The study uses electronic patient retrospect to collect baseline patient characteristics, sts treatment programmes and data on complications, and defines the endpoint of efficacy (complete healing/improvement of ulcer) through clinical evaluation by a doctor. The statistical methodology follows the ich e9 guidelines and uses sas v9. 4 for descriptive analysis. The queue comes mainly from the catalan medical institutions and ensures geographical representation of data。
Result
Patient characteristics: 93. 9 per cent caucasian, 78. 8 per cent post-menopausal, with an average age of 80. 81. 8 per cent combined with ckd (phases 2-3b), 72. 7 per cent used vitamin d supplements and 54. 5 per cent used vitamin k resistance. 90. 9 per cent were shown to be remote body ulcer。
Treatment programme: 84. 8 per cent of patients receive sts 25g iv three times a week, with a median treatment of 11. 4 weeks. Joint measures include plastic care (100 per cent), vitamin d (66. 7 per cent), bihydrate (33. 3 per cent) and antipressure treatment (21. 2 per cent)。
Treatment effectiveness and safety: 78. 8 per cent of patients achieve ulcer improvement or healing, but 96. 7 per cent have adverse effects, mainly metabolic acid poisoning (57. 6 per cent) and vomiting (54. 5 per cent). 9% require dose adjustment。
Post-natal analysis: 69. 7 per cent have serious complications (57. 6 per cent of ulcer infections) and the total mortality rate is 66. 7 per cent, of which 39. 4 per cent is directly or potentially attributable to nuc。
Discussion and significance
The study confirmed, for the first time, that sts had a treatment similar to that for nuc patients, but the high incidence of adverse events suggested the need for individualisation. It is worth noting that interventions such as vitamin d supplementation and anticondensation use account for over 70 per cent, providing a breakthrough for clinical prevention. Despite the limitations of the retrospective study, the results have created three key insights for nut's treatment:
Treatment strategy: sts joint multimodal intervention (creativity management + risk factors control) is a viable option; risk early warning: older women, ckd2-3 and vitamin d excess are highly vigilant; post-assessment: non-urea-toxic patients may survive better than the urea-toxic population, but infection control remains critical。
The study also revealed the unique pathological characteristic of nuc, the normality of the calcium metabolic index of up to 75 per cent, suggesting that its morbidity mechanism might be independent of traditional mineral matter disorders theory. This finding points to new directions for follow-up studies, such as exploring mechanisms such as intravascular cortex functional impairment or the absence of local calcification inhibitors. The paper concluded by emphasizing that the establishment of an international registration system would help to accelerate the standard-setting of nut consultations。
