Effects of sodium thiosulfate on vascular calcification in end-stage renal disease: a pilot study of feasibility, safety and efficacy.
OBJECTIVE
Vascular calcification is a major contributor to morbidity and mortality in hemodialysis. The objective of this pilot study was to determine the feasibility, safety and efficacy of sodium thiosulfate (STS) in the progression of vascular calcification in hemodialysis patients.


METHODS
Chronic hemodialysis patients underwent a battery of cardiovascular tests. Those with coronary artery calcium (Agatston scores >50) received intravenous STS after each dialysis for 5 months (n = 22) and the tests were repeated. Changes in MDCT-determined calcification were assessed as the mean annualized rate of change in 3 vascular beds (coronary, thoracic and carotid arteries) and in L1-L2 vertebral bone density.


RESULTS
Although individual analyses showed coronary artery calcification progression in 14/22 subjects, there was no progression in the mean annualized rate of change of vascular calcification in the entire group. The L1-L2 vertebral bone density showed no changes. There were no correlations between rates of progression of vascular calcification and phosphorus, fetuin or C-reactive protein levels. Changes in coronary artery calcification scores correlated with those of the thoracic aorta.


CONCLUSIONS
STS treatment is feasible, appears safe and may decrease the rate of progression of vascular calcification in hemodialysis patients. A large, randomized, controlled trial is warranted.
Cardiovascular Imaging and Clinical Research Core Laboratory and Cardiovascular Division, Washington University School of Medicine, St. Louis, Mo., USA.
Santhosh Jay
SJ
Mathews
Lisa
L
de las Fuentes
Prashanth
P
Podaralla
Anton
A
Cabellon
Sijie
S
Zheng
Andrew
A
Bierhals
Karen
K
Spence
Eduardo
E
Slatopolsky
Victor G
VG
Davila-Roman
James A
JA
Delmez
D000368:Aged; D001013:Aorta, Thoracic / Q000473:pathology; D015519:Bone Density; D002097:C-Reactive Protein / Q000096:biosynthesis; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D004452:Echocardiography / Q000379:methods; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010758:Phosphorus / Q000097:blood; D010865:Pilot Projects; D006435:Renal Dialysis / Q000379:methods; D013885:Thiosulfates / Q000494:pharmacology*; D014463:Ultrasonography / Q000379:methods; D000509:alpha-Fetoproteins / Q000096:biosynthesis
D013885:Thiosulfates; D000509:alpha-Fetoproteins; D010758:Phosphorus; D002097:C-Reactive Protein; C017717:sodium thiosulfate
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