LAS VEGAS—Sodium thiosulfate may hold promise as a treatment for calciphylaxis in patients with end-stage renal disease (ESRD), researchers reported here at the National Kidney Foundation’s Spring Clinical Meetings.

Hilana Hatoum, MD, of McLaren Regional Medical Center in Flint, Mich., and collaborators described a series of three cases of calciphylaxis that responded to the medication. All three cases were in women. Each patient had painful erythematous patches that progressed to necrotic ulcers on their extremities. Two women had normal parathyroid hormone (PTH), calcium, and phosphorus levels. These patients responded to a three-week regimen of sodium thiosulfate.

One woman had elevated PTH levels, which led to a diagnosis of secondary hyperparathyroidism that required parathyroidectomy followed by six weeks of sodium thiosulfate. She experienced complete healing of her ulcers.

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The authors concluded that sodium thiosulfate “may be tried as an adjunctive regimen, realizing that no clear evidence yet exists supporting its use.”

The researchers noted that calciphylaxis is rare, affecting 1%-4% of the chronic kidney disease population. It is characterized by progressive vascular calcification and ischemic necrosis of skin and soft tissue, they noted.