Multi-Modal Treatment Of Calciphylaxis With Sodium-Thiosulfate, Cinacalcet And Sevelamer Including Long-Term Data
Background: Calciphylaxis is a rare, yet life-threatening disease mainly occurring in dialysis patients. Traditional options of treatment remain unsatisfactory. Methods: Here we present a novel, combined approach, treating calciphylaxis with IV sodium thiosulfate, cinacalcet and sevelamer. In a case...
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| Format: | Article |
| Language: | English |
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Karger Publishers
2013-09-01
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| Series: | Kidney & Blood Pressure Research |
| Subjects: | |
| Online Access: | http://www.karger.com/Article/FullText/350162 |
| _version_ | 1819277318101663744 |
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| author | Hermann Salmhofer Michael Franzen Wolfgang Hitzl Josef Koller Bernhard Kreymann Falko Fend Cornelia Hauser-Kronberger Uwe Heemann Frieder Berr Christoph Schmaderer |
| author_facet | Hermann Salmhofer Michael Franzen Wolfgang Hitzl Josef Koller Bernhard Kreymann Falko Fend Cornelia Hauser-Kronberger Uwe Heemann Frieder Berr Christoph Schmaderer |
| author_sort | Hermann Salmhofer |
| collection | DOAJ |
| description | Background: Calciphylaxis is a rare, yet life-threatening disease mainly occurring in dialysis patients. Traditional options of treatment remain unsatisfactory. Methods: Here we present a novel, combined approach, treating calciphylaxis with IV sodium thiosulfate, cinacalcet and sevelamer. In a case series five hemodialysis patients, have been successfully treated with this regimen. Treatment and survival data were analyzed using descriptive statistics. Results: In all patients, a rapid decrease in pain, improvement of general condition and wound healing within six months occurred. Side effects were low. Drug dosages: IV sodium thiosulfate initial dose 119.4 +/- 84.9 g/m2/week, maintenance dose 40.6 +/- 9 g/m2/week; cinacalcet: maintenance dose 36 +/- 32.9 mg/d and sevelamer maintenance dose 3320 +/-1671 mg/d. One and two year survivals were 100 % and 80 %, respectively. We also report on long-term application of IV sodium thiosulfate of up to 52 months. Patient survival after diagnosis was 52, 84, 21, 36 and 30 months, respectively. Survival since initiation of hemodialysis was 76, 136, 89, 36 and 35 months, respectively. Conclusion: This novel combined approach, a multi-modal treatment of calciphylaxis with persistent hyperparathyroidism, using IV sodium thiosulfate, cinacalcet and sevelamer seems to improve the outcome of this devastating disease. |
| first_indexed | 2024-12-23T23:54:12Z |
| format | Article |
| id | doaj.art-9fc0648dc5744076a9cb6f09b12e58cb |
| institution | Directory Open Access Journal |
| issn | 1420-4096 1423-0143 |
| language | English |
| last_indexed | 2024-12-23T23:54:12Z |
| publishDate | 2013-09-01 |
| publisher | Karger Publishers |
| record_format | Article |
| series | Kidney & Blood Pressure Research |
| spelling | doaj.art-9fc0648dc5744076a9cb6f09b12e58cb2022-12-21T17:25:18ZengKarger PublishersKidney & Blood Pressure Research1420-40961423-01432013-09-01374-534635910.1159/000350162350162Multi-Modal Treatment Of Calciphylaxis With Sodium-Thiosulfate, Cinacalcet And Sevelamer Including Long-Term DataHermann SalmhoferMichael FranzenWolfgang HitzlJosef KollerBernhard KreymannFalko FendCornelia Hauser-KronbergerUwe HeemannFrieder BerrChristoph SchmadererBackground: Calciphylaxis is a rare, yet life-threatening disease mainly occurring in dialysis patients. Traditional options of treatment remain unsatisfactory. Methods: Here we present a novel, combined approach, treating calciphylaxis with IV sodium thiosulfate, cinacalcet and sevelamer. In a case series five hemodialysis patients, have been successfully treated with this regimen. Treatment and survival data were analyzed using descriptive statistics. Results: In all patients, a rapid decrease in pain, improvement of general condition and wound healing within six months occurred. Side effects were low. Drug dosages: IV sodium thiosulfate initial dose 119.4 +/- 84.9 g/m2/week, maintenance dose 40.6 +/- 9 g/m2/week; cinacalcet: maintenance dose 36 +/- 32.9 mg/d and sevelamer maintenance dose 3320 +/-1671 mg/d. One and two year survivals were 100 % and 80 %, respectively. We also report on long-term application of IV sodium thiosulfate of up to 52 months. Patient survival after diagnosis was 52, 84, 21, 36 and 30 months, respectively. Survival since initiation of hemodialysis was 76, 136, 89, 36 and 35 months, respectively. Conclusion: This novel combined approach, a multi-modal treatment of calciphylaxis with persistent hyperparathyroidism, using IV sodium thiosulfate, cinacalcet and sevelamer seems to improve the outcome of this devastating disease.http://www.karger.com/Article/FullText/350162CalciphylaxisCalcific uremic arteriolopathyEnd stage renal diseaseHyperparathyroidismSodium thiosulfateCinacalcetSevelamer |
| spellingShingle | Hermann Salmhofer Michael Franzen Wolfgang Hitzl Josef Koller Bernhard Kreymann Falko Fend Cornelia Hauser-Kronberger Uwe Heemann Frieder Berr Christoph Schmaderer Multi-Modal Treatment Of Calciphylaxis With Sodium-Thiosulfate, Cinacalcet And Sevelamer Including Long-Term Data Kidney & Blood Pressure Research Calciphylaxis Calcific uremic arteriolopathy End stage renal disease Hyperparathyroidism Sodium thiosulfate Cinacalcet Sevelamer |
| title | Multi-Modal Treatment Of Calciphylaxis With Sodium-Thiosulfate, Cinacalcet And Sevelamer Including Long-Term Data |
| title_full | Multi-Modal Treatment Of Calciphylaxis With Sodium-Thiosulfate, Cinacalcet And Sevelamer Including Long-Term Data |
| title_fullStr | Multi-Modal Treatment Of Calciphylaxis With Sodium-Thiosulfate, Cinacalcet And Sevelamer Including Long-Term Data |
| title_full_unstemmed | Multi-Modal Treatment Of Calciphylaxis With Sodium-Thiosulfate, Cinacalcet And Sevelamer Including Long-Term Data |
| title_short | Multi-Modal Treatment Of Calciphylaxis With Sodium-Thiosulfate, Cinacalcet And Sevelamer Including Long-Term Data |
| title_sort | multi modal treatment of calciphylaxis with sodium thiosulfate cinacalcet and sevelamer including long term data |
| topic | Calciphylaxis Calcific uremic arteriolopathy End stage renal disease Hyperparathyroidism Sodium thiosulfate Cinacalcet Sevelamer |
| url | http://www.karger.com/Article/FullText/350162 |
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