Abstract：
Guidelines are lacking for patients with calciphylaxis on renal replacement therapy, often leading to difficulty optimally treating these patients. A 60-year-old male veteran receiving hemodialysis presented with calciphylaxis of the left lower extremity and intractable pain. His condition was complicated by chronic back pain, long-term opioid therapy, and psychological trauma history. He was ultimately transferred to a calciphylaxis treatment center but was unable to tolerate further treatments due to sepsis and hemodynamic instability. He was transitioned to comfort measures and died in the hospital. Addressing complicated pain physiologies and complex trauma is challenging even in well-resourced tertiary medical centers. Despite the availability of calciphylaxis therapies and trauma-informed care, there remains a high rate of suffering and mortality in this patient population. There is much work to be done in this cohort, particularly when considering the implications of past traumatic experiences on health care engagement and pain management.
摘要：
缺乏对钙化患者进行肾脏替代治疗的指南，通常导致难以最佳治疗这些患者。一名接受血液透析的60岁男性退伍军人表现为左下肢钙化和顽固性疼痛。他的病情因慢性背痛而变得复杂，长期阿片类药物治疗，和心理创伤史。他最终被转移到钙化治疗中心，但由于败血症和血流动力学不稳定而无法耐受进一步的治疗。他被转为采取安慰措施，并在医院死亡。即使在资源充足的三级医疗中心，解决复杂的疼痛生理和复杂的创伤也具有挑战性。尽管有钙化预防疗法和创伤知情护理，在这一患者人群中，痛苦和死亡率仍然很高。在这个群体中有很多工作要做，特别是在考虑过去的创伤经历对医疗保健参与和疼痛管理的影响时。
