title: Successful treatment of calcific uremic arteriolopathy with sodium thiosulfate in a renal transplant recipient.
abstract: Abstract   Calcific uremic arteriolopathy (CUA) is a rare but life-threatening disorder of arteriolar calcification. It frequently leads to severe ischemia, intense pain, and tissue necrosis with non-healing skin ulcerations. CUA usually occurs in patients with chronic kidney disease (CKD), especially those on dialysis, and its occurrence is rare in kidney transplant recipients. The treatment of this disorder is not clearly defined, and no randomized prospective trials are available. Treatment has focused on optimizing dialysis treatment, control of bone mineral parameters, wound care, experimental anticalcification therapies-using bisphosphonates, cinacalcet, parathyroidectomy, and hyperbaric oxygen. Such treatments are based on the pathophysiological considerations and evidences from case reports or series. Recently, several cases have reported about the emerging benefits of intravenous sodium thiosulfate (STS) in the treatment of CUA. STS has resulted in rapid pain relief, wound healing, and prevention of death. We report a case of CUA in a 63-year-old Caucasian man with a functioning renal allograft. In this patient, intravenous STS was administered for 8 months, which was the principal therapy, which resulted in complete resolution of the CUA and skin healing.
authors.affiliation: Department of Renal Medicine, Flinders Medical Centre, Bedford Park, SA, Australia. jordan.li@health.sa.gov.au
authors.forename: Jordan Y Z
authors.initials: JY
authors.lastname: Li
authors.forename: Tuck Y
authors.initials: TY
authors.lastname: Yong
authors.forename: Muhammad
authors.initials: M
authors.lastname: Choudhry
authors.forename: Nitesh
authors.initials: N
authors.lastname: Rao
authors.forename: Caroline
authors.initials: C
authors.lastname: Milton
authors.forename: Rajiv
authors.initials: R
authors.lastname: Juneja
authors.forename: Jeffrey A J
authors.initials: JA
authors.lastname: Barbara
authors.forename: George
authors.initials: G
authors.lastname: Passaris
mesh_terms: D002614:Chelating Agents / Q000008:administration & dosage / Q000627:therapeutic use; D005500:Follow-Up Studies; D006801:Humans; D007262:Infusions, Intravenous; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D013885:Thiosulfates / Q000008:administration & dosage / Q000627:therapeutic use*; D014511:Uremia / Q000150:complications* / Q000601:surgery; D061205:Vascular Calcification / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology
chemical_list: D002614:Chelating Agents; D013885:Thiosulfates; C017717:sodium thiosulfate