Penile calciphylaxis in patients with end-stage kidney disease undergoing dialysis: Invasive treatment and pain management

Introduction Penile calciphylaxis is rarely reported in dialysis patients. Methods We experienced cases of dialysis patients who had penile calciphylaxis between 2003 and 2020. Results Seven patients undergoing dialysis were treated for penile necrosis (hemodialysis [HD], 5; peritoneal dialysis [PD], 1; hybrid therapy comprising PD and HD, 1). Their mean age was 62.8 years and their mean dialysis vintage 116.1 months. All had severe penile pain and were clinically diagnosed with calciphylaxis. Four received partial penectomy and three received percutaneous transluminal angioplasty (PTA) due to rapid aggravation. The number of analgesia types and the critical-care pain observation tool score significantly decreased after invasive treatment (both, p = 0.008). The 90-day and 1-year survival rates after onset were 85.7% and 57.1%, respectively. Conclusion In dialysis patients, penile calciphylaxis has poor prognosis; however, invasive treatments for pain management are effective. PTA may be beneficial in dialysis patients in poor condition.