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Unexpectedly Severe Metabolic Acidosis Associated with Sodium Thiosulfate Therapy in a Patient with Calcific Uremic Arteriolopathy
Ist Teil von
Seminars in dialysis, 2011-01, Vol.24 (1), p.85-88
Ort / Verlag
Oxford, UK: Blackwell Publishing Ltd
Erscheinungsjahr
2011
Link zum Volltext
Quelle
MEDLINE
Beschreibungen/Notizen
Calcific uremic arteriolopathy, formerly known as calciphylaxis is a devastating condition that primarily affects patients with end‐stage renal disease. The lesions can progress to massive ulcerations of the subcutaneous tissue that are associated with a high degree of morbidity and mortality, usually related to sepsis. Although the pathophysiology of this condition is poorly understood, it appears to be related to a derangement in calcium–phosphate metabolism. Thus, treatments have focused on the treatment of hyperparathyroidism albeit with poor results. More recently, sodium thiosulfate (STS) has emerged as a promising therapy following multiple case reports of marked disease regression following its use. As STS is a strong acid, metabolic acidosis has been described following its administration, although relatively mild in degree. We report a case of a patient with calciphylaxis who repeatedly developed a severe anion gap metabolic acidosis following each dose of STS requiring a significant reduction in the dose.