Possibly enhanced Gd excretion in dialysate, but no major clinical benefit of 3-5 months of treatment with sodium thiosulfate in late stages of nephrogenic systemic fibrosis.
BACKGROUND
Gd-related nephrogenic systemic fibrosis was successfully treated with intravenous sodium thiosulfate according to a recent case report.


METHODS
Four haemodialysis patients with severe Gd-related nephrogenic systemic fibrosis were treated with intravenous sodium thiosulfate for 3-5 months. Symptoms and patients' experiences were investigated. The dialysate Gd content was monitored.


RESULTS
We observed no major clinical improvements in any patient. In one patient, we found slightly improved joint motion. Two patients had a subjective impression of slight improvements of joint motion and skin abnormalities. The dialysate Gd content was raised by the treatment, up to fivefold.


CONCLUSIONS
We could not confirm that sodium thiosulfate treatment results in marked and rapid improvement in late stages of Gd-related nephrogenic systemic fibrosis. However, dialysate contents of Gd seemed to increase. It is unknown whether increased Gd excretion will lead to long-term clinical improvements in late stages of nephrogenic systemic fibrosis.
Marckmann
Peter
P
Department of nephrology, Copenhagen University Hospital Herlev, Herlev Ringvej 75, DK-2730 Herlev, Denmark. peter.marckmann@dadlnet.dk
Nielsen
Arne Høj
AH
Sloth
Jens Jørgen
JJ
D000328:Adult; D002614:Chelating Agents / Q000627:therapeutic use; D003287:Contrast Media / Q000009:adverse effects / Q000493:pharmacokinetics; D005260:Female; D005682:Gadolinium / Q000009:adverse effects* / Q000493:pharmacokinetics*; D019786:Gadolinium DTPA / Q000009:adverse effects / Q000493:pharmacokinetics; D015312:Hemodialysis Solutions / Q000032:analysis; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000009:adverse effects; D008875:Middle Aged; D054989:Nephrogenic Fibrosing Dermopathy / Q000188:drug therapy* / Q000209:etiology* / Q000378:metabolism / Q000517:prevention & control; D006435:Renal Dialysis; D051437:Renal Insufficiency / Q000175:diagnosis; D013885:Thiosulfates / Q000627:therapeutic use*; D013997:Time Factors
D002614:Chelating Agents; D003287:Contrast Media; D015312:Hemodialysis Solutions; D013885:Thiosulfates; C064925:gadodiamide; D005682:Gadolinium; C017717:sodium thiosulfate; D019786:Gadolinium DTPA