title: Sodium thiosulfate-based treatment in calcific uremic arteriolopathy: a consecutive case series.
abstract: BACKGROUND
  Calcific uremic arteriolopathy (CUA) is a rare complication in end stage renal disease with high mortality. Numerous case reports and one case series of 3 patients report the benefit of sodium thiosulfate (STS) for treatment of CUA. The purpose of this evaluation was to examine the response to a STS-based treatment approach in patients with CUA with 1 year follow up.
  
  
  METHODS
  A retrospective case series of 6 consecutive patients from Manitoba, Canada who met predefined diagnostic criteria for CUA and received STS between 2006 and 2008 were included. STS responders were defined as improvement in at least one of the following three parameters: pain severity, wound size and diagnostic imaging/radiography. Mortality, STS dose, duration, adverse events and cost were also collected.
  
  
  RESULTS
  Four patients were classified as responders. The 2 responders who survived at 1 year of follow-up demonstrated an improvement in all 3 parameters examined including an improvement in their follow-up diagnostic imaging results within the first 4 - 6 weeks of STS treatment. At 1 year of follow-up, 3 patients died.
  
  
  CONCLUSIONS
  Using an STS-based multifaceted treatment approach for CUA, 4 patients responded but 3 of 6 patients died within 1 year. Further larger prospective studies are needed to delineate STS responders from non-responders.
authors.affiliation: University of Manitoba, Winnipeg, Manitoba, Canada. msood@sbgh.mb.ca
authors.forename: A R
authors.initials: AR
authors.lastname: Sood
authors.forename: L D
authors.initials: LD
authors.lastname: Wazny
authors.forename: C B
authors.initials: CB
authors.lastname: Raymond
authors.forename: K
authors.initials: K
authors.lastname: Leung
authors.forename: P
authors.initials: P
authors.lastname: Komenda
authors.forename: M
authors.initials: M
authors.lastname: Reslerova
authors.forename: M
authors.initials: M
authors.lastname: Verrelli
authors.forename: C
authors.initials: C
authors.lastname: Rigatto
authors.forename: M M
authors.initials: MM
authors.lastname: Sood
mesh_terms: D000328:Adult; D001157:Arterial Occlusive Diseases / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology / Q000401:mortality; D002115:Calciphylaxis / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology / Q000401:mortality; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000401:mortality / Q000628:therapy; D008297:Male; D008350:Manitoba; D008875:Middle Aged; D010146:Pain / Q000209:etiology / Q000517:prevention & control; D010530:Peritoneal Dialysis; D012189:Retrospective Studies; D013885:Thiosulfates / Q000627:therapeutic use*; D013997:Time Factors; D016896:Treatment Outcome; D014511:Uremia / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology / Q000401:mortality; D014945:Wound Healing / Q000187:drug effects
chemical_list: D013885:Thiosulfates; C017717:sodium thiosulfate