Russ P, et al. - Only in patients with clinical features and histomorphological proof of calciphylaxis, researchers investigated concomitant factors in the development of calciphylaxis. Overall 15 patients were analyzed in an 8 year period in this single center retrospective study. Patients had mean age of 64.8 years. Intimal hyperplasia, micro thrombi or von Kossa stain positive media calcification were required to be present for histological diagnosis of calciphylaxis. In particular, treatment with vitamin K antagonists and liver dysfunction were identified as the most significant concomitant factors in development of calciphylaxis. Possibly, early use of direct oral anticoagulants instead of vitamin K antagonists would benefit and attenuate the incidence of calciphylaxis because progression and development of calciphylaxis are chronic rather than acute processes.