Monatshefte für Chemie - Chemical Monthly

, Volume 148, Issue 3, pp 435–440 | Cite as

Serum calcium and phosphorus concentrations and the outcome of calciphylaxis treatment with sodium thiosulfate

  • Jiri Hlusicka
  • Eva Veisova
  • Martin Ullrych
  • Jaroslav Kubecek
  • Tomas Navratil
  • Sergey Zakharov
Original Paper
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Accepted:
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Abstract

Calciphylaxis is severe condition with 45–55 % mortality occurring in chronic dialysis patients. Sporadically, the disease may develop in the patients with normal renal function, for example, in the presence of chronic renal inflammation. Sodium thiosulfate (STS) therapy is a treatment modality of calciphylaxis, but mechanism of its action is unknown. We report four cases of calciphylaxis treated with STS, illustrating that its therapeutic effect is not associated with decreased serum calcium or phosphorus concentration. Therapy with intravenous STS was safe and led to subjective improvement, due to pain reduction, and lesions healing in three of four patients. In one patient, complications of diabetes and other co-morbidities led to unfavorable outcome. STS can be considered promising drug in the treatment of calciphylaxis.

Graphical abstract

Keywords

Calciphylaxis Sodium thiosulfate Serum calcium Serum phosphorus Treatment Outcome 
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Notes

Acknowledgments

The authors acknowledge the financial support of the Projects of the Charles University in Prague P25/1LF/2 and P28/1LF/6.

Compliance with ethical standards

Ethics

The study was approved by the General University Hospital Ethics Committee in Prague, Czech Republic.

References

  1. 1.
    Musso CG, Enz P, Vidal F, Gelman R, Lizarraga A, Di Giuseppe L, Kowalczuk A, Garfi L, Galimberti R, Algranati L (2009) Saudi J Kidney Dis Transpl 20:1065Google Scholar
  2. 2.
    Brandenburg VM, Cozzolino M, Ketteler M (2011) J Nephrol 24:142CrossRefGoogle Scholar
  3. 3.
    Weenig RH (2008) J Am Acad Dermatol 58:458CrossRefGoogle Scholar
  4. 4.
    Nigwekar SU, Kroshinsky D, Nazarian RM, Goverman J, Malhotra R, Jackson VA, Kamdar MM, Steele DJ, Thadhani RI (2015) Am J Kidney Dis 66:133CrossRefGoogle Scholar
  5. 5.
    Salmhofer H, Franzen M, Hitzl W, Koller J, Kreymann B, Fend F, Hauser-Kronberger C, Heemann U, Berr F, Schmaderer C (2013) Kidney Blood Press Res 37:346CrossRefGoogle Scholar
  6. 6.
    Zitt E, König M, Vychytil A, Auinger M, Wallner M, Lingenhel G, Schilcher G, Rudnicki M, Salmhofer H, Lhotta K (2013) Nephrol Dial Transpl 28:1232CrossRefGoogle Scholar
  7. 7.
    Zakharov S, Pelclova D, Navratil T, Belacek J, Kurcova I, Komzak O, Salek T, Latta J, Turek R, Bocek R, Kucera C, Hubacek JA, Fenclova Z, Petrik V, Cermak M, Hovda KE (2014) Kidney Int 86:199CrossRefGoogle Scholar
  8. 8.
    Guldbakke KK, Khachemoune A (2007) Int J Dermatol 46:231CrossRefGoogle Scholar
  9. 9.
    Daudén E, Oñate MJ (2008) Dermatol Clin 26:557CrossRefGoogle Scholar
  10. 10.
    Rees JK, Coles GA (1969) Br Med J 2:670CrossRefGoogle Scholar
  11. 11.
    Selye H, Gentile G, Prioreschi P (1961) Science 134:1876CrossRefGoogle Scholar
  12. 12.
    Ketteler M, Biggar HP, Brandenburg VM, Schlieper G, Westenfeld R, Floege J (2007) Dtsch Arztebl 104:3481Google Scholar
  13. 13.
    Lipsker D, Chosidow O, Martinez F, Challier E, Francès C (1997) Arch Dermatol 133:798CrossRefGoogle Scholar
  14. 14.
    Russell R, Brookshire MA, Zekonis M, Moe SM (2002) Clin Nephrol 58:238CrossRefGoogle Scholar
  15. 15.
    Alikadic N, Kovac D, Krasna M, Lindic J, Sabovic M, Tomazic J, Jeras M, Smrke D (2009) Clin Transpl 23:968CrossRefGoogle Scholar
  16. 16.
    Cicone JS, Petronis JB, Embert CD, Spector DA (2004) Am J Kidney Dis 43:1104CrossRefGoogle Scholar
  17. 17.
    Zakharov S, Vaneckova M, Seidl Z, Diblik P, Kuthan P, Urban P, Navratil T, Pelclova D (2015) Basic Clin Pharmacol Toxicol 117:209CrossRefGoogle Scholar
  18. 18.
    Yatzidis H (1985) Clin Nephrol 23:63Google Scholar
  19. 19.
    Zakharov S, Navratil T, Pelclova D (2012) Basic Clin Pharmacol Toxicol 110:427CrossRefGoogle Scholar
  20. 20.
    Zakharov S, Navratil T, Pelclova D (2012) Ups J Med Sci 117:309CrossRefGoogle Scholar
  21. 21.
    Yu Z, Gu L, Pang H, Fang Y, Yan H, Fang W (2015) Case Rep Nephrol Dial 5:77CrossRefGoogle Scholar
  22. 22.
    Bryson DP (1996) Comprehensive reviews in toxicology: for emergency clinicians. CRC Press, p 361Google Scholar
  23. 23.
    Araya CE, Fennell RS, Neiberger RE, Dharnidharka VR (2006) Clin J Am Soc Nephrol 1:1161CrossRefGoogle Scholar
  24. 24.
    Pasch A, Schaffner T, Huynh-Do U, Frey BM, Frey FJ, Farese S (2008) Kidney Int 74:1444CrossRefGoogle Scholar
  25. 25.
    Hayden MR, Goldsmith DJ (2010) Sodium thiosulfate: new hope for the treatment of calciphylaxis. In: Seminars in dialysis, p 258Google Scholar
  26. 26.
    New N, Mohandas J, John GT, Ratanjee S, Healy H, Francis L, Ranganathan D (2011) Int J Nephrol ID 982854Google Scholar
  27. 27.
    Adirekkiat S, Sumethkul V, Ingsathit A, Domrongkitchaiporn S, Phakdeekitcharoen B, Kantachuvesiri S, Kitiyakara C, Klyprayong P, Disthabanchong S (2010) Nephrol Dial Transplant 25:1923CrossRefGoogle Scholar
  28. 28.
    Farah M, Crawford RI, Levin A, Yan CC (2011) Nephrol Dial Transplant 26:191CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Wien 2016

Authors and Affiliations

  • Jiri Hlusicka
    • 1
  • Eva Veisova
    • 2
  • Martin Ullrych
    • 3
  • Jaroslav Kubecek
    • 4
  • Tomas Navratil
    • 5
  • Sergey Zakharov
    • 1
  1. 1.Department of Occupational Medicine, First Faculty of MedicineCharles University in Prague and General University Hospital in PraguePrague 2Czech Republic
  2. 2.Department of DialysisCharles University in Prague and General University HospitalPrague 2Czech Republic
  3. 3.Department of Internal medicineHospital DecinDecinCzech Republic
  4. 4.Department of Internal MedicineHospital NachodNachodCzech Republic
  5. 5.J. Heyrovský Institute of Physical Chemistry of the AS CRv.v.i.Prague 8Czech Republic

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