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Kidney Week

Abstract: FR-PO442

Effectiveness and Safety of Modified Sodium Thiosulfate Therapy for Calciphylaxis in Chinese Patients

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Yang, Xin, Institute of Nephrology, Zhong Da Hospital, Southeast University School of Medicine, Nanjing, China
  • Liu, Yuqiu, Institute of Nephrology, Zhong Da Hospital, Southeast University School of Medicine, Nanjing, China
  • Xie, Xiaotong, Institute of Nephrology, Zhong Da Hospital, Southeast University School of Medicine, Nanjing, China
  • Ni, Haifeng, Institute of Nephrology, Zhong Da Hospital, Southeast University School of Medicine, Nanjing, China
  • Zhang, Xiaoliang, Institute of Nephrology, Zhong Da Hospital, Southeast University School of Medicine, Nanjing, China
  • Liu, Bi-Cheng, Institute of Nephrology, Zhong Da Hospital, Southeast University School of Medicine, Nanjing, China

Group or Team Name

  • Institute of Nephrology, Zhong Da Hospital, Southeast University School of Medicine,Nanjing
Background

Calciphylaxis is a generally fatal condition without acknowledged effective treatment. Some case reports and clinical studies have described intravenous sodium thiosulfate (STS) prevent the progression of calciphylaxis. Nevertheless, this therapy for individuals presented serious complications resulting in withdrawal of treatment in our experience. Based on the ethnic diversity, we modified the usage of STS and evaluated the effectiveness and safety of modified STS therapy for calciphylaxis in Chinese patients.

Methods

20 patients who were diagnosed calciphylaxis and treated with STS in our center were enrolled. Evaluation of effectiveness and safety was based on items including demographics, clinical data and laboratory measurements. Therapeutic schedule were named Zhongda Therapy with 5 course of treatment and 2-3weeks of interrupt between 2 courses. STS from the initial dose (3.2g) were administered intravenously in 100 ml once a day gradually increasing day by day up to the highest dose (6.4g). Patients maintained the condition of highest dose for 2-3 weeks and finished one course of treatment.

Results

The Mean age of the cohort was 45.50±14.95 years, 75% of patients was male and the median time span was 87 (52, 120) months range from entering the dialysis to diagnosed as calcipylaxis. In our research, 90% patients got improved and 12/20 patients were follow-up more than 12 months with 100% one-year survival rate. Of these patients, lesions involved different body parts such torso, limb, fingertips or compound type and throughout the body were 20% with powerful pain. The therapy relieved pain and promote early healing of skin lesions, even help one avert amputation. Reduction of phosphorus (P=0.035) and the NPRS (P<0.001) correlated significantly with STS treatment courses. Although adverse events occurs up to the 35% (nausea/vomiting 10%, hypotension 10%, infection 5% and multi-complication 10%), no one interrupted treatment due to mild discomfort. And if the incidence rate were calculated according to frequency divided by the total course, it will reduced to 14%.

Conclusion

Chinese patients need to modified the usage of STS to treat the calciphylaxis. And Zhongda Therapy offered a safe and effective treatment.