Sodium Thiosulfate Treatment for Calciphylaxis: Is There an Optimal Duration of Therapy?

Hemodialysis international. International Symposium on Home Hemodialysis Pub Date : 2025-01-21 DOI:10.1111/hdi.13196

Julia Vaz, Eduardo Rosa, Luciene Magalhães, Rogério Matsuda, Rosa Maria Affonso Moysés, Vanda Jorgetti

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Abstract

Calciphylaxis is a rare and serious disorder characterized by vascular calcification and occlusion of the microvessels in the dermis, subcutaneous adipose tissue, visceral organs, and musculature. Studies have suggested that the major risk factors for developing calciphylaxis are chronic kidney disease and secondary hyperparathyroidism. Its diagnosis is clinical, and the treatment includes a multidisciplinary approach, although there are no clinical protocols based on randomized clinical trials. Therefore, the management and treatment are informed by specialist opinion. Sodium thiosulfate is frequently utilized for its vasodilatory and antioxidant properties, as well as its ability to chelate calcium. However, there are no guidelines regarding the duration of its use. The present report describes a chronic kidney disease patient on hemodialysis with calciphylaxis, who underwent sodium thiosulfate treatment for 2 years associated with debridement and reconstructive plastic surgery with a good response and control of the disease.

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硫代硫酸钠治疗钙化反应：是否有最佳治疗时间？

钙化症是一种罕见而严重的疾病，其特征是真皮、皮下脂肪组织、内脏器官和肌肉组织的血管钙化和微血管闭塞。研究表明，发生钙化反应的主要危险因素是慢性肾病和继发性甲状旁腺功能亢进。它的诊断是临床的，治疗包括多学科的方法，尽管没有基于随机临床试验的临床方案。因此，管理和治疗应听取专家意见。硫代硫酸钠因其血管扩张和抗氧化特性以及螯合钙的能力而经常被使用。然而，没有关于其使用时间的指导方针。本报告描述了一例慢性肾脏疾病伴钙化反应的血液透析患者，他接受了2年的硫代硫酸钠治疗，并伴有清创和重建整形手术，疾病得到了良好的反应和控制。

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Hemodialysis international. International Symposium on Home Hemodialysis

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