CALCIPHYLAXIS is the accumulation of calcium deposits in the small blood vessels of the skin and other organs, causing skin ulcers and painful tissue necrosis. It is not fully understood how sodium thiosulfate treats calciphylaxis, but research suggest that it functions by binding to calcium ions in the bloodstream and tissues, thereby inhibiting the formation of calcium deposits.
Christy Gossett and colleagues, Mayo Clinic in Rochester, Minnesota, and Jacksonville, Florida, USA, reported that treating calciphylaxis with sodium thiosulfate has been extensively investigated in patients undergoing haemodialysis, but not in patients on peritoneal dialysis. Administrating sodium thiosulfate to treat calciphylaxis in patients undergoing peritoneal dialysis has the potential to be successful, but adverse effects may arise.
The research team conducted a literature search and identified a total of 19 articles that focused on patients receiving peritoneal dialysis and undergoing treatment with sodium thiosulfate. The literature review revealed that the incidence of calciphylaxis was higher among patients on peritoneal dialysis, ranging from 4.1–40.2 cases per 1,000 patient years, compared with only 0.6–0.8 cases per 1,000 patient years among patients on haemodialysis.
The researchers presented critical findings on dosing, route of administration, successful healing, and adverse effects. Intraperitoneal dosing in patients (n=5) ranged from 12.5 g–25.0 g three to four times a week. Within this group, 6% of patients required sodium thiosulfate discontinuation due to adverse effects, while 44% had successful healing of wounds.
Out of the patients who transitioned from intravenous to intraperitoneal dosing, two experienced healed wounds, while one patient unfortunately passed away due to sepsis. The authors concluded that the use of sodium thiosulfate in patients on peritoneal dialysis can successful, but significant adverse effects may arise. Large-scale studies and comprehensive pharmacological data are requisite to establish the optimal dose, efficacy, and administration route.
