NDT Advance Access originally published online on May 3, 2005
Nephrology Dialysis Transplantation 2005 20(6):1260-1262; doi:10.1093/ndt/gfh825
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© The Author [2005]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oupjournals.org
Interesting Case
Rapid resolution of calciphylaxis with intravenous sodium thiosulfate and continuous venovenous haemofiltration using low calcium replacement fluid: case report
Division of Nephrology, Hypertension and Transplantation, University of Florida, Gainesville, FL, USA
Correspondence and offprint requests to: Edward A. Ross, MD, Division of Nephrology, Hypertension and Transplantation, University of Florida, Box 100224, Gainesville, FL 32610-0224, USA. Email: rossea@medicine.ufl.edu
Keywords: calcific uraemic arteriolopathy; calciphylaxis; thiosulfate
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Introduction |
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The pathogenesis of calciphylaxis (calcific uremic arteriolopathy) remains to be fully elucidated, which makes treatment of this often fatal disease quite challenging. While controversial, vascular calcium deposition may play a secondary, if not primary, role in ongoing tissue ischemia. In cases that would not benefit from early parathyroidectomy, alternative strategies have been proposed to control calcium and phosphate homeostasis. The use of non-calcium based phosphate binders and intermittent haemodialysis with low calcium dialysate [1,2] has been of benefit in some but not all patients. One of the most recently suggested therapies is the use of sodium thiosulfate to increase the solubility of calcium deposits [3]. With its reported success in treating both nephrolithiasis [3] and tumoral calcinosis [4,5], Cicone et al. [6] described its efficacy when given after haemodialysis treatments in a single case of calciphylaxis.
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