The role of sodium thiosulphate in the treatment of calciphylaxis

Calciphylaxis is a rare but important cause of severe morbidity, which predominantly affects patients with advanced chronic kidney disease. It is associated with mortality in excess of 50% at one year, and this has changed little over the last 20 years despite advances in our understanding of its underlying pathophysiology, and evolving treatment strategies. Sodium thiosulphate has played a prominent role in the treatment of calciphylaxis since its first use in 2004, with reports of success both in improving the severe pain associated with the condition and in the healing of calciphylaxis lesions. The literature documenting the use of sodium thiosulphate in the treatment of calciphylaxis is reviewed here, along with a detailed summary of case reports and case series. While there is reason to be optimistic with regard to the efficacy of sodium thiosulphate within a multifaceted and multidisciplinary approach to treatment, there is clearly much yet to be learned