Serum calcium and phosphorus concentrations and the outcome of calciphylaxis treatment with sodium thiosulfate

Calciphylaxis is severe condition with 45-55 % mortality occurring in chronic dialysis patients. Sporadically, the disease may develop in the patients with normal renal function, for example, in the presence of chronic renal inflammation. Sodium thiosulfate (STS) therapy is a treatment modality of calciphylaxis, but mechanism of its action is unknown. We report four cases of calciphylaxis treated with STS, illustrating that its therapeutic effect is not associated with decreased serum calcium or phosphorus concentration. Therapy with intravenous STS was safe and led to subjective improvement, due to pain reduction, and lesions healing in three of four patients. In one patient, complications of diabetes and other co-morbidities led to unfavorable outcome. STS can be considered promising drug in the treatment of calciphylaxis.